Consultant Terms and Conditions

Terms and Conditions Consultants (England) 2003
DEFINITIONS ....................................................................................................... 2
Schedule 1 Commencement of employment ..................................................... 5
Schedule 2 Associated duties and responsibilities ............................................. 6
Schedule 3 Job planning ................................................................................... 7
Schedule 4 Mediation and appeals .................................................................... 10
Schedule 5 Recognition for emergency work arising from on-call duties ............ 12
Schedule 6 Extra programmed activities and spare professional capacity ......... 14
Schedule 7 Premium time .................................................................................. 16
Schedule 8 On-call rotas ................................................................................... 17
Schedule 9 Provisions governing the relationship between NHS work, private
practice and fee paying services ..................................................... 18
Schedule 10 Fee paying services ........................................................................ 21
Schedule 11 Principles governing receipt of additional fees................................. 24
Schedule 12 Other conditions of employment ...................................................... 25
Schedule 13 Basic salary and payment for additional programmed activities
for consultants appointed before 31 October 2003 .......................... 27
Schedule 14 Basic salary and payment for additional programmed activities
for consultants appointed after 31 October 2003 ............................. 33
Schedule 15 Pay thresholds ................................................................................ 37
Schedule 16 Pay supplements ............................................................................ 39
Schedule 17 Pension arrangements .................................................................... 42
Schedule 18 Leave and public holidays ............................................................... 43
Schedule 19 Termination of employment ............................................................. 48
Schedule 20 Incorporated general council conditions of service .......................... 49
Schedule 21 Model provisions for expenses NHS consultants........................... 51
Schedule 22 Locum consultants .......................................................................... 64
Schedule 23 Application of terms and conditions of service for NHS consultant
clinical academics ........................................................................... 66
Schedule 24 Maternity Leave and Pay (Temporary Schedule) ............................ 69
Schedule 25 Employment Break Scheme (Temporary Schedule) ........................ 80
Schedule 26 Redundancy Pay (Temporary Schedule)......................................... 83
Schedule 27 Caring for Children and Adults (Temporary Schedule)........ 89
Schedule 28 Flexible Working Arrangements (Temporary Schedule) . 91
Schedule 29 Balancing Work and Personal Life (Temporary Schedule).. 93
The terms and conditions set out in this document shall incorporate, and be read,
subject to any amendments which are from time to time the subject of negotiation by
the appropriate negotiation bodies and are approved by the Secretary of State after
considering the results of such negotiations. Any amendments should be published.
Version 1 - 20 October 2003

Version 2 - 19 January 2004
Version 3 1 June 2005
Version 4 1 March 2007
Version 5 2 April 2007
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Version 6 30 July 2007
Version 7 1 April 2008
Version 8 1 September 2009
Version 9 - 31 March 2013
DEFINITIONS
Contractual and Consequential Services: the work that a consultant carries out by
virtue of the duties and responsibilities set out in his or her Job Plan and any work
reasonably incidental or consequential to those duties. These services may include:
Direct Clinical Care
Supporting Professional Activities
Additional NHS Responsibilities
External Duties.
Direct Clinical Care: work directly relating to the prevention, diagnosis or treatment
of illness that forms part of the services provided by the employing organisation
under section 3(1) or section 5(1)(b) of the National Health Service Act 1977. This
includes emergency duties (including emergency work carried out during or arising
from on-call), operating sessions including pre-operative and post-operative care,
ward rounds, outpatient activities, clinical diagnostic work, other patient treatment,
public health duties, multi-disciplinary meetings about direct patient care and
administration directly related to the above (including but not limited to referrals and
notes).
Supporting Professional Activities: activities that underpin Direct Clinical Care.

This may include participation in training, medical education, continuing professional
development, formal teaching, audit, job planning, appraisal, research, clinical
management and local clinical governance activities.
Additional NHS Responsibilities: special responsibilities not undertaken by the

generality of consultants in the employing organisation which are agreed between a
consultant and the employing organisation and which cannot be absorbed within the
time that would normally be set aside for Supporting Professional Activities. These
include being a Medical Director, Director of Public Health, Clinical Director or lead
clinician, or acting as a Caldicott guardian, clinical audit lead, clinical governance
lead, undergraduate dean, postgraduate dean, clinical tutor or regional education
adviser. This is not an exhaustive list.
External Duties: duties not included in any of the three foregoing definitions and not
included within the definition of Fee Paying Services or Private Professional
Services, but undertaken as part of the Job Plan by agreement between the
consultant and employing organisation. These might include trade union duties,
undertaking inspections for the Commission for Health Improvement (or its successor
body), acting as an external member of an Advisory Appointments Committee,
undertaking assessments for the National Clinical Assessment Authority, reasonable
quantities of work for the Royal Colleges in the interests of the wider NHS,
reasonable quantities of work for a Government Department, or specified work for the
General Medical Council. This list of activities is not exhaustive.
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Emergency Work:
Predictable emergency work: this is emergency work that takes place at regular and
predictable times, often as a consequence of a period of on-call work (e.g. post-take
ward rounds). This should be programmed into the working week as scheduled
Programmed Activity.
Unpredictable emergency work arising from on-call duties: this is work done whilst
on-call and associated directly with the consultants on-call duties (except in so far as
it takes place during a time for scheduled Programmed Activities), e.g. recall to
hospital to operate on an emergency basis.
For the purposes of Schedule 3, paragraph 6, non-emergency work shall be

regarded as including the regular, programmed work of consultants whose specialty
by its nature involves dealing routinely with emergency cases, e.g. A&E consultants.
Fee Paying Services: any paid professional services, other than those falling within
the definition of Private Professional Services, which a consultant carries out for a
third party or for the employing organisation and which are not part of, nor reasonably
incidental to, Contractual and Consequential Services. A third party for these
purposes may be an organisation, corporation or individual, provided that they are
acting in a health related professional capacity, or a provider or commissioner of
public services. Examples of work that fall within this category can be found in
Schedule 10 of the Terms and Conditions.
Private Professional Services (also referred to as private practice): such

services as include:
the diagnosis or treatment of patients by private arrangement (including
such diagnosis or treatment under section 65(2) of the National Health
Service Act 1977), excluding fee paying services as described in
Schedule 10 of the terms and conditions
work in the general medical, dental or ophthalmic services under Part II of
the National Health Service Act 1977 (except in respect of patients for
whom a hospital medical officer is allowed a limited list, e.g. Members of
the hospital staff).
Professional and Study Leave: professional leave or study leave in relation to

professional work including:
study, usually but not exclusively or necessarily on a course or
programme
research
teaching
examining or taking examinations
visiting clinics and attending professional conferences
participation in training.
Programmed Activity: a scheduled period, nominally equivalent to four hours,

during which a consultant undertakes Contractual and Consequential Services.
Premium Time: any time that falls outside the period 07:00 to 19:00 Monday to
Friday, and any time on a Saturday or Sunday, or public holiday.
General Council Conditions: The National Health Service Staff conditions of

service of general application as determined by the General Council of the Whitley
Councils for the Health Services (Great Britain) as may be amended from time to
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time, or any provisions which may be agreed by a successor body to the General
Council and may reasonably be considered to have replaced the current conditions
of service.
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Schedule 1 Commencement of employment
1. The date from which employment under this contract began must be stated in
clause 2.1 of the consultants contract of employment.2
2. The date from which continuous employment as a consultant began for the
purposes of the Employment Rights Act 1996 must be set out in clause 2.2 of
the contract of employment and should include, if applicable, employment with
predecessor organisations that had previously held the contract, e.g. former
Regional Health Authorities from whom the current contract was transferred
under TUPE or equivalent arrangements. Previous employment with other
NHS employing organisations does not count as continuous service for the
purposes of the Employment Rights Act 1996 except as provided for under the
National Health Service and Community Care Act 1990 or any other statute.3
Calculation of seniority
3. NHS organisations should take into account all previous service as a
consultant with other NHS employing organisations and any equivalent
experience in another EEA Member State. The employing organisation may, at
its discretion, take into account service outside the NHS, for example including:
employment outside the EEA
voluntary service
employment in the independent sector
service in HM armed forces.4
On appointment to a Consultant post, Associate Specialists should be paid in line

with Schedule 14 paragraph 11.56
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Schedule 2 Associated duties and responsibilities
1. A consultant has continuing clinical and professional responsibility for patients
admitted under his or her care or, (for consultants in public health medicine) for
a local population. It is also the duty of a consultant to:
keep patients (and/or their carers if appropriate) informed about their
condition
involve patients (and/or their carers if appropriate) in decision making
about their treatment
maintain professional standards and obligations as set out from time to
time by the General Medical Council (GMC) and comply in particular with
the GMCs guidance on Good Medical Practice as amended or
substituted from time to time.
maintain professional standards and obligations as set out from time to
time by the General Dental Council (GDC) (Dental consultants only).
2. A consultant is responsible for carrying out any work related to and reasonably
incidental to the duties set out in their Job Plan such as:
the keeping of records and the provision of reports
the proper delegation of tasks
maintaining skills and knowledge.
3. Consultants shall be expected in the normal run of their duties to deputise for
absent consultant or associate specialist colleagues so far as is practicable,
even if on occasions this would involve interchange of staff within the same
employing organisation. This does not include deputising where an associate
specialist colleague is on a rota with doctors in training. When deputising is not
practicable, the employing organisation (and not the consultant) shall be
responsible for the engagement of a locum tenens, but the consultant shall
have the responsibility of bringing the need to the employers notice. The
employing organisation shall assess the number of Programmed Activities
required.
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Schedule 3 Job planning
General principles
1. Job planning will be based on a partnership approach. The clinical manager
will prepare a draft job plan, which will then be discussed and agreed with the
consultant. Job plans will list all the NHS duties of the consultant, the number
of Programmed Activities for which the consultant is contracted and paid, the
consultants objectives and agreed supporting resources.
Job content
2. The Job Plan will set out all of a consultants NHS duties and responsibilities
and the service to be provided for which the consultant is accountable. The
Job Plan will include any duties for other NHS employers. A standard full-time
Job Plan will contain ten Programmed Activities. Subject to the provisions in
Schedule 7 for recognising work done in Premium Time, a Programmed
Activity will have a timetable value of four hours. Programmed Activities may
be programmed as blocks of four hours or in half-units of two hours each.
3. The duties and responsibilities set out in a Job Plan will include, as appropriate:
Direct Clinical Care duties including on-call work
Supporting Professional Activities
Additional NHS Responsibilities
External Duties
Travelling Time as defined in Schedule 12, paragraphs 10-11.
Job schedule
4. The Job Plan will include a schedule of Programmed Activities setting out how,
when and where the consultants duties and responsibilities will be delivered.
It is expected that Programmed Activities will normally take place at a
consultants principal place of work but there will be flexibility to agree off site
working where appropriate. The clinical manager will draw up the schedule
after full discussion with the consultant, taking into account the consultants
views on resources and priorities and making every effort to reach agreement. .
5. The employer will be responsible for ensuring that a consultant has the
facilities, training development and support needed to deliver the commitments
in the job plan and will make all reasonable endeavours to ensure that this
support conforms with the standards set out in Improving Working Lives.
6. Non emergency work after 7pm and before 7am during weekdays or at
weekends will only be scheduled by mutual agreement between the consultant
and his or her clinical manager. Consultants will have the right to refuse non-
emergency work at such times. Should they do so there will be no detriment in
relation to pay progression or any other matter.
7. Where a consultant is required to participate in an on-call rota, the Job Plan will
set out the frequency of the rota.
Managerial responsibilities
8. The Job Plan will set out the consultants management responsibilities.
Accountability arrangements
9. The Job Plan will set out the consultants accountability arrangements, both
professional and managerial.
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.
Objectives
10. The Job Plan will include appropriate and identified personal objectives that
have been agreed between the consultant and his or her clinical manager and
will set out the relationship between these personal objectives and local service
objectives. Where a consultant works for more than one NHS employer, the
lead employer will take account of any objectives agreed with other employers.
11. The nature of a consultants personal objectives will depend in part on his or
her specialty, but they may include objectives relating to:
quality
activity and efficiency
clinical outcomes
clinical standards
local service objectives
management of resources, including efficient use of NHS resources
service development
multi-disciplinary team working.
12. Objectives may refer to protocols, policies, procedures and work patterns to be
followed. Where objectives are set in terms of output and outcome measures,
these must be reasonable and agreement should be reached.
13. The objectives will set out a mutual understanding of what the consultant will
be seeking to achieve over the annual period that they cover and how this will
contribute to the objectives of the employing organisation. They will:
be based on past experience and on reasonable expectations of what
might be achievable over the next period
reflect different, developing phases in the consultants career
be agreed on the understanding that delivery of objectives may be
affected by changes in circumstances or factors outside the consultants
control, which will be considered at the Job Plan review.
Supporting resources
14. The consultant and his or her clinical manager will use Job Plan reviews to
identify the resources that are likely to be needed to help the consultant carry
out his or her Job Plan commitments over the following year and achieve his or
her agreed objectives for that year.
15. The consultant and his or her clinical manager will also use Job Plan reviews to
identify any potential organisational or systems barriers that may affect the
consultants ability to carry out the Job Plan commitments or to achieve agreed
objectives.
16. The Job Plan will set out:

agreed supporting resources, which may include facilities, administrative,
clerical or secretarial support, office accommodation, IT resources and
other forms of support;
any action that the consultant and/or employing organisation agree to take
to reduce or remove potential organisational or systems barriers.
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Job plan review
17. The Job Plan will be reviewed annually. The annual review will examine all
aspects of the Job Plan and should be used to consider amongst other
possible issues:
what factors affected the achievement or otherwise of objectives
adequacy of resources to meet objectives
any possible changes to duties or responsibilities, or the schedule of
Programmed Activities
ways of improving management of workload
the planning and management of the consultants career.
18. The annual review will be informed by the same information systems that serve
the appraisal process and by the outcome of the appraisal discussions.
19. The annual Job Plan review may result in a revised prospective Job Plan.
20. In the case of consultants with more than one NHS employer, a lead employer
will normally be designated to conduct the Job Plan review on behalf of all the
consultants employers. The lead employer will take full account of the views of
other employers (including for the purposes of Schedule 5) and inform them of
the outcome.
21. Following the annual Job Plan review, the clinical manager will report the
outcome, via the Medical Director, to the Chief Executive and copied to the
consultant, setting out for the purposes of decisions on pay thresholds whether
the criteria in Schedule 15 have been met.
22. The consultant and clinical manager may conduct an interim review of the Job
Plan where duties, responsibilities, accountability arrangements or objectives
have changed or need to change significantly within the year. In particular, in
respect of the agreed objectives in the Job Plan, both the consultant and
clinical manager will:
keep progress against those objectives under review
identify to each other any problems in meeting those objectives as they
emerge
propose an interim Job Plan review if it appears that the objectives may
not be achieved for reasons outside the consultants control.
Resolving disagreements over job plans

23. The consultant and clinical manager will make every effort to agree any
appropriate changes to the Job Plan at the annual or interim review. If it is not
possible to reach agreement on the Job Plan, the consultant may refer to
mediation and, if necessary, appeal as set out in Schedule 4.
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Schedule 4 Mediation and appeals
1. Where it has not been possible to agree a Job Plan, or a consultant disputes a
decision that he or she has not met the required criteria for a pay threshold in
respect of a given year, a mediation procedure and an appeal procedure are
available.
Mediation
2. The consultant, or (in the case of a disputed Job Plan) the clinical manager,
may refer the matter to the Medical Director, or to a designated other person if
the Medical Director is one of the parties to the initial decision. Where a
consultant is employed by more than one NHS organisation, a designated
employer will take the lead (in the case of a disputed Job Plan, a lead employer
should have already been identified). The purposes of the referral will be to
reach agreement if at all possible. The process will be that:
the consultant or clinical manager makes the referral in writing within two
weeks of the disagreement arising;
the party making the referral will set out the nature of the disagreement
and his or her position or view on the matter;
where the referral is made by the consultant, the clinical manager
responsible for the Job Plan review, or (as the case may be) for making
the recommendation as to whether the criteria for pay thresholds have
been met, will set out the employing organisations position or view on the
matter;
where the referral is made by the clinical manager, the consultant will be
invited to set out his or her position on the view or matter;
the Medical Director or appropriate other person will convene a meeting,
normally within four weeks of receipt of the referral, with the consultant
and the responsible clinical manager to discuss the disagreement and to
hear their views;
if agreement is not reached at this meeting, then the Medical Director will
decide the matter (in the case of a decision on the Job Plan) or make a
recommendation to the Chief Executive (in the case of a decision on
whether the criteria for a pay threshold have been met) and inform the
consultant and the responsible clinical manager of that decision or
recommendation in writing;
in the case of a decision on whether the criteria for a pay threshold have
been met, the Chief Executive will inform the consultant, the Medical
Director and the responsible clinical manager of his or her decision in
writing;
if the consultant is not satisfied with the outcome, he or she may lodge a
formal appeal.
Formal appeal
3. A formal appeal panel will be convened only where it has not been possible to
resolve the disagreement using the mediation process. A formal appeal will be
heard by a panel under the procedure set out below.
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4. An appeal shall be lodged in writing to the Chief Executive as soon as possible,
and in any event within two weeks, after the outcome of the mediation process.
The appeal should set out the points in dispute and the reasons for the appeal.
The Chief Executive will, on receipt of a written appeal, convene an appeal
panel to meet within four weeks.
5. The membership of the panel will be:

a chair nominated by the appellants employing organisation;
a second panel member nominated by the appellant consultant;
a third member chosen from a list of individuals approved by the
Strategic Health Authority and the BMA and BDA. The Strategic
Health Authority will monitor the way in which individuals are allocated
to appeal panels to avoid particular individuals being routinely called
upon. If there is an objection raised by either the consultant or the
employing organisation to the first representative from the list, one
alternative representative will be allocated. The list of individuals will
be regularly reviewed.5
No member of the panel should have previously been involved in the dispute.
6. The parties to the dispute will submit their written statements of case to the
appeal panel and to the other party one week before the appeal hearing. The
appeal panel will hear oral submissions on the day of the hearing.
Management will present its case first explaining the position on the Job Plan,
or the reasons for deciding that the criteria for a pay threshold have not been
met.
7. The consultant may present his or her own case in person, or be assisted by a
work colleague or trade union or professional organisation representative, but
legal representatives acting in a professional capacity are not permitted.
8. Where the consultant, the employer or the panel requires it, the appeals panel
may hear expert advice on matters specific to a speciality.
9. It is expected that the appeal hearing will last no more than one day.
10. The appeal panel will make a recommendation on the matter in dispute in
writing to the Board of the employing organisation, normally within two weeks
of the appeal having been heard and this will normally be accepted. The
consultant should see a copy of the recommendation when it is sent to the
Board. The Board will make the final decision and inform the parties in writing.
11. No disputed element of the Job Plan will be implemented until confirmed by the
outcome of the appeals process. Any decision that affects the salary or pay of
the consultant will have effect from the date on which the consultant referred
the matter to mediation or from the time he or she would otherwise have
received a change in salary, if earlier.
12. In the case of a job planning appeal from a Medical Director or Director of
Public Health, mediation would take place via a suitable individual, for example,
a Non-Executive Director.
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Schedule 5 Recognition for emergency work arising from
on-call duties
1. The expected average amount of time that a consultant is likely to spend on
unpredictable emergency work each week whilst on-call and directly associated
with his or her on-call duties will be treated as counting towards the number of
Direct Clinical Care Programmed Activities that the consultant is regarded as
undertaking. This will be up to a maximum average of one Programmed
Activity per week until 31 March 2005 and a maximum average of two
Programmed Activities per week from 1 April 2005.
2. Where the unpredictable emergency work arising from a consultants on-call

duties significantly exceeds the equivalent of two Programmed Activities on
average per week, the clinical manager and the consultant will review the
position. In exceptional circumstances, the employing organisation may agree
additional arrangements with the consultant to recognise work in excess of this
limit, either by additional remuneration or time off. The clinical manager and
the consultant should also consider whether some of the work is sufficiently
regular and predictable to be programmed into the working week on a
prospective basis. If no arrangements are made the default position is to
trigger a job plan review.
3. The employing organisation will assess with the consultant, on a prospective

basis, the number of Programmed Activities that are to be regarded for these
purposes as representing the average weekly volume of unpredictable
emergency work arising from a consultants on-call duties during a period of
between one and eight weeks. This will be based on a periodic assessment of
the average weekly amount of such work over a prior reference period. The
consultant will be the key player in the assessment by maintaining records of
his/her activities. The employing organisation will agree the reference period
with the consultant.
4. Tables 1 and 2 below set out illustrations of the relationship between the
average weekly emergency work arising from on-call duties and the number of
Programmed Activities that this work is regarded as representing. The general
principle is that an average of four hours of such work per week, or subject to
the provisions in Schedule 7, and from April 2004, an average of three hours of
such work per week during Premium Time constitutes for these purposes one
Programmed Activity, up to a maximum of one Programmed Activity until 31
March 2005 and a maximum of two Programmed Activities from 1 April 2005.
5. Table 1 illustrates possible ways of allocating Programmed Activities for these

purposes, during the transitional period or where the emergency work in
question does not arise during Premium Time.
Table 1
Average emergency work per Possible allocation of Programmed Activities
week likely to arise from on- (PAs)
call duties
hour 1 PA every 8 weeks, or a half-PA every 4 weeks
1 hour 1 PA every 4 weeks, or a half-PA every 2 weeks
1 hours 3 PAs every 8 weeks
2 hours 1 PA every 2 weeks, or a half-PA every week
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week likely to arise from on- (PAs)
call duties
4 hours 1 PA per week
6 hours 1 PAs per week, or 3 PAs every 2 weeks
8 hours 2 PAs per week
6. Table 2 illustrates possible ways of allocating Programmed Activities for these

purposes, where from April 2004 the emergency work in question arises during
Premium Time.
Table 2 Applicable from 1 April 2004

week likely to arise during (PAs)
Premium Time from on-call
duties
hour 1 PA every 6 weeks, or a half-PA every 3 weeks
1 hour 1 PA every 3 weeks
1 hours 1 PA every 2 weeks, or a half-PA per week
3 hours 1 PA per week
4 hours 3 PAs every two weeks
6 hours 2 PAs per week
7. Where on-call work averages less than 30 minutes per week, compensatory
time will be deducted from normal Programmed Activities on an ad hoc basis.
8. Where a consultants on-call duties give rise to a different amount of time spent
on unpredictable emergency work than assumed in this prospective
assessment, the clinical manager and the consultant will review the position at
a Job Plan review and, where appropriate, agree adjustments on a prospective
basis. Where this results in a reduction in the level of recognition, the new
arrangements will take immediate effect without any period of protection. A
whole time consultant has the right to maintain a full time salary. Where such a
reduction would otherwise result in a working week of fewer than ten
Programmed Activities, the consultant should have the option of accepting
other duties to maintain a full time salary. Similar protection will apply to part-
timers.
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Schedule 6 Extra programmed activities and spare
professional capacity
1. Where a consultant intends to undertake remunerated clinical work that falls
under the definition of Private Professional Services other than such work
specified in his or her Job Plan, whether for the NHS, for the independent
sector, or for another party, the provisions in this Schedule will apply.
2. Where a consultant intends to undertake such work:

the consultant will first consult with his or her clinical manager
the employing organisation may, but is not obliged to, offer the consultant
the opportunity to carry out under these Terms and Conditions (including
the remuneration arrangements contained in these Terms and Conditions)
up to one extra Programmed Activity per week on top of the standard
commitment set out in his or her contract of employment, subject to the
provisions in paragraph 7 for consultants who have previously held a
maximum part-time NHS consultant contract
additional Programmed Activities may be offered on a fixed basis, but
where possible the employing organisation will offer them on a mutually
agreed annualised basis. Where consultants prospectively agree to extra
Programmed Activities these will be remunerated;
where possible, the employing organisation will put any such offer to the
consultant at the annual Job Plan review but, unless the employing
organisation and consultant agree otherwise, no fewer than three months
in advance of the start of the proposed extra Programmed Activities, or six
months in advance where the work would mean the consultant has to re-
schedule external commitments;
there will be a minimum notice period of three months for termination of
these additional activities. If a consultant ceases to undertake Private
Professional Services, he/she may relinquish the additional Programmed
Activity subject to a similar notice period;
the employing organisation will give all clinically appropriate consultants
an equal opportunity to express an interest in undertaking these additional
activities. Any offer or acceptance should be made in writing;
full-time consultants who are currently working the equivalent of 11 or
more Programmed Activities and agree with their clinical manager that the
same level of activity should form part of their Job Plan under the new
contract will not be expected to offer any additional work on top of this;
part-time consultants who wish to use some of their non-NHS time to do
private practice will not be expected to offer any more than one extra
Programmed Activity on top of their normal working week.
3. If a consultant declines the opportunity to take up additional Programmed

Activities that are offered in line with the provisions above, and the consultant
subsequently undertakes remunerated clinical work as defined above, this will
constitute one of the grounds for deferring a pay threshold in respect of the
year in question. If another consultant in the group accepts the work, there will
be no impact on pay progression for any consultant in the group.
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4. Where a consultant works for more than one NHS employer, the employers
concerned may each offer additional Programmed Activities, but the consultant
will not be expected to undertake on average any more than one Programmed
Activity per week to meet the relevant criterion for pay thresholds. The job
planning process should be used to agree for which employing organisation
any additional Programmed Activities should be undertaken.
5. Should there be any significant increase in the time a part-time consultant

working between seven and nine Programmed Activities devotes to Private
Professional Services, the consultant will notify the employing organisation and
the consultant and employing organisation may review the number of
Programmed Activities in the consultants Job Plan.
6. The provisions in this Schedule are without prejudice to the possibility that the
consultant and employing organisation may wish to agree extra programmed
activities up to the maximum level consistent with the Working Time
Regulations.
Transitional provisions
7. For the first year under these Terms and Conditions (2003/04), the number of
extra Programmed Activities that the employing organisation may offer, for the
purposes of the provisions above, to consultants who have previously held a
maximum part-time NHS consultant contract will not exceed an average of one
extra Programmed Activity every three weeks. For the second year under
these Terms and Conditions (2004/05), the number will not exceed an average
of one extra Programmed Activity every two weeks. As provided by paragraph
6 above, this does not preclude the possibility of arranging additional
Programmed Activities by mutual agreement.
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Schedule 7 Premium time
1. From 1 April 2004, the following provisions will apply to recognise the unsocial
nature of work done in Premium Time and the flexibility required of consultants
who work at these times as part of a more varied overall working pattern.
Scheduled work
2. For each Programmed Activity scheduled during Premium Time there will be a
reduction in the timetable value of the Programmed Activity itself to three hours
or a reduction in the timetable value of another Programmed Activity by one
hour, subject to a maximum reduction of three hours per week.
3. If, by mutual agreement, a Programmed Activity in Premium Time lasts for four
hours or more, an equivalent enhancement to payment may be agreed.
4. Where a Programmed Activity falls only partly in Premium Time, the reduction
in the timetable value of this or another Programmed Activity will be on an
appropriate pro rata basis. If an enhancement to payment is made this will be
applied to the proportion of the Programmed Activity falling within Premium
Time.
Unpredictable emergency work arising from on-call duties

5. In assessing the number of Programmed Activities needed to recognise
unpredictable emergency work arising from on-call duties under the provisions
in Schedule 5, the employing organisation will treat three hours of
unpredictable emergency work done in Premium Time as equivalent to one
Programmed Activity. The provisions of paragraph 3 may also apply.
Work in premium time exceeding three programmed activities per week

6. The foregoing provisions are designed to cover situations where work in
Premium Time is up to the equivalent of three Programmed Activities per week
on average. Where work during Premium Time exceeds this average, the
employing organisation and the consultant will agree appropriate
arrangements.
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Schedule 8 On-call rotas
Duty to be contactable
1. Subject to the following provisions, the consultant must ensure that there are
clear and effective arrangements so that the employing organisation can
contact him or her immediately at any time during a period when he or she is
on-call.
2. The only exception to this requirement is where a consultants on-call duties

have been assessed as falling within category B described in Schedule 16 and
the employing organisation and the consultant have agreed in advance that the
consultant may arrange short intervals during an on-call period during which it
will not be possible for him or her to be contacted straight away. In these
circumstances, the consultant must ensure that:
the intervals in question have been agreed with the employing
organisation in advance and clearly recorded;
there are arrangements for messages to be taken if the employing
organisation contacts the consultant during such an interval;
the consultant can and does respond immediately after such an interval.
High frequency rotas

3. Where a consultant or consultants are on a rota of 1 in 4 or more frequent, the
employing organisation will review at least annually the reasons for this rota
and for its high frequency and take any practicable steps to reduce the need for
high-frequency rotas of this kind. The views of consultants will be taken into
account.
4. Where unusually a consultant is asked to be resident at the hospital or other

place of work during his or her on-call period, appropriate arrangements may
be agreed locally. A consultant will only be resident during an on-call period by
mutual agreement.
Private professional services and fee paying services

5. Subject to the following provisions, a consultant will not undertake Private
Professional Services or Fee Paying Services when on on-call duty. The
exceptions to this rule are where:
the consultants rota frequency is 1 in 4 or more frequent, his or her on-
call duties have been assessed as falling within the category B described
in Schedule 16, and the employing organisation has given prior approval
for undertaking specified Private Professional Services or Fee Paying
Services;
the consultant has to provide emergency treatment or essential continuing
treatment for a private patient. If the consultant finds that such work
regularly impacts on his or her NHS commitments, he or she will make
alternative arrangements to provide emergency cover for private patients.
17
Schedule 9 Provisions governing the relationship between
NHS work, private practice and fee paying
services
1. This Schedule should be read in conjunction with the Code of Conduct for
Private Practice, which sets out standards of best practice governing the
relationship between NHS work, private practice and fee paying services.
2. The consultant is responsible for ensuring that the provision of Private

Professional Services or Fee Paying Services for other organisations does not:
result in detriment of NHS patients or services;
diminish the public resources that are available for the NHS.
Disclosure of information about private commitments

3. The consultant will inform his or her clinical manager of any regular
commitments in respect of Private Professional Services or Fee Paying
Services. This information will include the planned location, timing and broad
type of work involved.
4. The consultant will disclose this information at least annually as part of the Job
Plan Review. The consultant will provide information in advance about any
significant changes to this information.
Scheduling of work and job planning

5. Where there would otherwise be a conflict or potential conflict of interest, NHS
commitments must take precedence over private work. Subject to paragraphs
10 and 11 below, the consultant is responsible for ensuring that private
commitments do not conflict with Programmed Activities.
6. Regular private commitments must be noted in the Job Plan.
7. Circumstances may also arise in which a consultant needs to provide

emergency treatment for private patients during time when he or she is
scheduled to be undertaking Programmed Activities. The consultant will make
alternative arrangements to provide cover if emergency work of this kind
regularly impacts on the delivery of Programmed Activities.
8. The consultant should ensure that there are arrangements in place, such that
there can be no significant risk of private commitments disrupting NHS
commitments, e.g. by causing NHS activities to begin late or to be cancelled. In
particular where a consultant is providing private services that are likely to
result in the occurrence of emergency work, he or she should ensure that there
is sufficient time before the scheduled start of Programmed Activities for such
emergency work to be carried out.
9. Where the employing organisation has proposed a change to the scheduling of

a consultants NHS work, it will allow the consultant a reasonable period in line
with Schedule 6, paragraph 2 to rearrange any private commitments. The
employing organisation will take into account any binding commitments that the
consultant may have entered into (e.g. leases). Should a consultant wish to
reschedule private commitments to a time that would conflict with Programmed
18
Activities, he or she should raise the matter with the clinical manager at the
earliest opportunity.
Scheduling private commitments whilst on-call

10. The consultant will comply with the provisions in Schedule 8, paragraph 5 of
these Terms and Conditions.
11. In addition, where a consultant is asked to provide emergency cover for a

colleague at short notice and the consultant has previously arranged private
commitments at the same time, the consultant should only agree to do so if
those commitments would not prevent him or her returning to the relevant NHS
site at short notice to attend an emergency. If the consultant is unable to
provide cover at short notice it will be the employing organisations
responsibility to make alternative arrangements.
Use of NHS facilities and staff

12. Except with the employing organisations prior agreement, a consultant may
not use NHS facilities or NHS staff for the provision of Private Professional
Services or Fee Paying Services for other organisations.
13. The employing organisation has discretion to allow the use of its facilities and
will make it clear which facilities a consultant is permitted to use for private
purposes and to what extent.
14. Should a consultant, with the employing organisations permission, undertake

Private Professional Services or Fee Paying Services in any of the employing
organisations facilities, the consultant should observe the relevant provisions
in the Code of Conduct for Private Practice.
15. Where a patient pays privately for a procedure that takes place in the
employing organisations facilities, that procedure should take place at a time
that does not impact on normal services for NHS patients. Except in
emergencies, such procedures should occur only where the patient has given a
signed undertaking to pay any charges (or an undertaking has been given on
the patients behalf) in accordance with the employing organisations
procedures.
16. Private patients should normally be seen separately from scheduled NHS
patients. Only in unforeseen and clinically justified circumstances should a
consultant cancel or delay a NHS patients treatment to make way for his or her
private patient.
17. Where the employing organisation agrees that NHS staff may assist a
consultant in providing Private Professional Services, or provide private
services on the consultants behalf, it is the consultants responsibility to ensure
that these staff are aware that the patient has private status.
18. The consultant has an obligation to ensure, in accordance with the employing
organisations procedures, that any patient whom the consultant admits to the
employing organisations facilities is identified as private and that the
responsible manager is aware of that patients status.
19. The consultant will comply with the employing organisations policies and
procedures for private practice.
19
Patient enquiries about private treatment
20. Where, in the course of his or her duties, a consultant is approached by a
patient and asked about the provision of Private Professional Services, the
consultant may provide only such standard advice as has been agreed with the
employing organisation for such circumstances.
21. The consultant will not during the course of his or her Programmed Activities
make arrangements to provide Private Professional Services, nor ask any other
member of staff to make such arrangements on his or her behalf, unless the
patient is to be treated as a private patient of the employing organisation.
22. In the course of his/her Programmed Activities, a consultant should not initiate
discussions about providing Private Professional Services for NHS patients,
nor should the consultant ask other staff to initiate such discussions on his or
her behalf.
23. Where a NHS patient seeks information about the availability, or waiting times,
for NHS services and/or Private Professional Services, the consultant is
responsible for ensuring that any information he or she provides, or arranges
for other staff to provide on his or her behalf is accurate and up-to-date.
Promoting improved patient access to NHS care

24. Subject to clinical considerations, the consultant is expected to contribute as
fully as possible to reducing waiting times and improving access and choice for
NHS patients. This should include ensuring that patients are given the
opportunity to be treated by other NHS colleagues or by other providers where
this will reduce their waiting time and facilitating the transfer of such patients.
Increasing NHS capacity

25. The consultant will make all reasonable efforts to support initiatives to increase
NHS capacity, including appointment of additional medical staff and changes to
ways of working.
20
Schedule 10 Fee paying services
1. Fee Paying Services are services that are not part of Contractual or
Consequential Services and not reasonably incidental to them. Fee Paying
Services include:
a. work on a person referred by a Medical Adviser of the Department for Work
and Pensions, or by an Adjudicating Medical Authority or a Medical Appeal
Tribunal, in connection with any benefits administered by an Agency of the
Department for Work and Pensions;
b. work for the Criminal Injuries Compensation Board, when a special
examination is required or an appreciable amount of work is involved in
making extracts from case notes;
c. work required by a patient or interested third party to serve the interests of
the person, his or her employer or other third party, in such non-clinical
contexts as insurance, pension arrangements, foreign travel, emigration, or
sport and recreation. (This includes the issue of certificates confirming that
inoculations necessary for foreign travel have been carried out, but
excludes the inoculations themselves. It also excludes examinations in
respect of the diagnosis and treatment of injuries or accidents);
d. work required for life insurance purposes;
e. work on prospective emigrants including X-ray examinations and blood
tests;
f. work on persons in connection with legal actions other than reports which
are incidental to the consultants Contractual and Consequential Duties, or
where the consultant is giving evidence on the consultants own behalf or
on the employing organisations behalf in connection with a case in which
the consultant is professionally concerned;
g. work for coroners, as well as attendance at coroners' courts as medical
witnesses;
h. work requested by the courts on the medical condition of an offender or
defendant and attendance at court hearings as medical witnesses,
otherwise than in the circumstances referred to above;
i. work on a person referred by a medical examiner of HM Armed Forces
Recruiting Organisation;
j. work in connection with the routine screening of workers to protect them or
the public from specific health risks, whether such screening is a statutory
obligation laid on the employing organisation by specific regulation or a
voluntary undertaking by the employing organisation in pursuance of its
general liability to protect the health of its workforce;
k. occupational health services provided under contract to other NHS,
independent or public sector employers;
l. work on a person referred by a medical referee appointed under the
Workmen's Compensation Act 1925 or under a scheme certified under
section 31 of that Act;
m. work on prospective students of universities or other institutions of further
education, provided that they are not covered by Contractual and
Consequential Services. Such examinations may include chest
radiographs;
21
n. examinations and recommendations under Part II of the Mental Health Act
1983 (except where the patient is an in-patient), where it follows
examination at an out-patient clinic or where given as a result of a
domiciliary consultation:
if given by a doctor who is not on the staff of the hospital where the
patient is examined; or
if the recommendation is given as a result of a special examination
carried out at the request of a local authority officer at a place other
than a hospital or clinic administered by a NHS organisation;
o. services performed by members of hospital medical staffs for government
departments as members of medical boards;
p. work undertaken on behalf of the Employment Medical Advisory Service in
connection with research/survey work, i.e. the medical examination of
employees intended primarily to increase the understanding of the cause,
other than to protect the health of people immediately at risk (except where
such work falls within Contractual and Consequential Services);
q. completion of Form B (Certificate of Medical Attendant) and Form C
(Confirmatory Medical Certificate) of the cremation certificates;
r. examinations and reports including visits to prison required by the Prison
Service which do not fall within the consultants Contractual and
Consequential Services and which are not covered by separate contractual
arrangements with the Prison Service;
s. examination of blind or partially-sighted persons for the completion of form
BD8, except where the information is required for social security purposes,
or an Agency of the Department for Work and Pensions, or the
Employment Service, or the patient's employer, unless a special
examination is required, or the information is not readily available from
knowledge of the case, or an appreciable amount of work is required to
extract medically correct information from case notes
2. Fee Paying Services may also include work undertaken by public health
consultants, including services to a local or public authority of a kind not
provided by the NHS, such as:
a. work as a medical referee (or deputy) to a cremation authority and signing
confirmatory cremation certificates;
b. medical examination in relation to staff health schemes of local authorities
and fire and police authorities;
c. lectures to other than NHS staff;
d. medical advice in a specialised field of communicable disease control;
e. work for water authorities, including medical examinations in relation to
staff health schemes;
f. attendance as a witness in court;
g. medical examinations and reports for commercial purposes, e.g.
certificates of hygiene on goods to be exported or reports for insurance
companies;
h. advice to organisations on matters on which the consultant is
acknowledged to be an expert;
22
i. examinations and recommendations under Part II of the Mental Health Act
1983.
23
Schedule 11 Principles governing receipt of additional fees
1. In the case of the following services, the consultant will not be paid an
additional fee, or - if paid a fee - the consultant must remit the fee to the
employing organisation:
any work in relation to the consultants Contractual and Consequential
Services;
duties which are included in the consultants Job Plan, including any
additional Programmed Activities which have been agreed with the
employing organisation;
fee paying work for other organisations carried out during the consultants
Programmed Activities, unless the work involves minimal disruption and
the employing organisation agrees that the work can be done in NHS time
without the employer collecting the fee;
domiciliary consultations carried out during the consultants Programmed
Activities;
lectures and teaching during the course of the consultants clinical duties;
lectures and teaching that are not part of the consultants clinical duties,
but are undertaken during the consultants Programmed Activities.
This list is not exhaustive and as a general principle, work undertaken during
Programmed Activities will not attract additional fees.
2. Services for which the consultant can retain any fee that is paid:
Fee Paying Services carried out in the consultants own time, or during
annual or unpaid leave;
Fee Paying Services carried out during the consultants Programmed
Activities that involve minimal disruption to NHS work and which the
employing organisation agrees can be done in NHS time without the
employer collecting the fee;
domiciliary consultations undertaken in the consultants own time, though
it is expected that such consultations will normally be scheduled as part of
Programmed Activities; 1
Private Professional Services undertaken in the employing organisations
facilities and with the employing organisations agreement during the
consultants own time or during annual or unpaid leave;
Private Professional Services undertaken in other facilities during the
consultants own time, or during annual or unpaid leave;
lectures and teaching that are not part of the consultants clinical duties
and are undertaken in the consultants own time or during annual or
unpaid leave.
This list is not exhaustive but as a general principle the consultant is entitled to
the fees for work done in his or her own time, or during annual or unpaid leave.
1
And only for a visit to the patients home at the request of a general practitioner and
normally in his or her company to advise on the diagnosis or treatment of a patient who on
medical grounds cannot attend hospital.
24
Schedule 12 Other conditions of employment
Outside employment and financial interests
1. A consultant must declare:
any financial interest or relationship with an external organisation he or
she may have which may conflict with the policies, business activity and
decisions of the employing organisation; and/or
any financial or pecuniary advantage he or she may gain whether directly
or indirectly as a result of a privileged position within the employing
organisation.
Private residence
2. A consultant is required to reside within a distance of 30 minutes or ten miles
by road from their principal place of work unless an employing organisation
agrees that they may reside at a greater distance.
3. A consultant must be contactable by telephone.
Health assessment
4. Consultants are required to notify their clinical manager as soon as possible of
any illness, disease or condition, which prevents them from undertaking their
duties.
5. The employer may at any time require a consultant who is unable to perform
his or her duties as a consequence of illness to submit to an examination by
the organisations occupational health services.
Research
6. All research must be managed in accordance with the requirements of the
Department of Health Research Governance Framework. Consultants must
comply with all reporting requirements, systems and duties of action put in
place by the employing organisation to deliver research governance.
Consultants must also comply with the GMC guidance Good Practice in
Research as from time to time amended.
Publications
7. A consultant shall be free, without prior consent of the employing organisation,
to publish books articles, etc and to deliver any lecture or speak, whether on
matters arising out of his or her NHS service or not.
Confidentiality
8. A consultant has an obligation not to disclose any information of a confidential
nature concerning patients, employees, contractors or the confidential business
of the organisation.
Public interest disclosure

9. Should a consultant have cause for genuine concern about an issue (including
one that would normally be subject to the above paragraph) and believes that
disclosure would be in the public interest, he or she should have a right to
speak out and be afforded statutory protection and should follow local
procedures 2 for disclosure of information in the public interest.
2
As required under the Public Interest Disclosure Act 1998 (PIDA).
25
Travelling time
10. Where consultants are expected to spend time on more than one site during
the course of a day, travelling time to and from their main base to other sites
will be included as working time.
11. Travel to and from work for NHS emergencies, and excess travel will count as
working time. Excess travel is defined as time spent travelling between home
and a working site other than the consultants main place of work, after
deducting the time normally spent travelling between home and main place of
work. Employers and consultants may need to agree arrangements for dealing
with more complex working days. Travelling time between a consultants main
place of work and home or private practice premises will not be regarded as
part of working time.
26
Schedule 13 Basic salary and payment for additional
programmed activities for consultants appointed
before 31 October 200342
1. This Schedule applies to those whose first appointment as a NHS consultant
was before 31 October 2003. Schedule 14 applies to those whose first
appointment as a NHS consultant was on or after 31 October 2003. For the
purposes of determining whether this Schedule or Schedule 14 applies, the
date of appointment will be regarded as the date on which the consultant post
was offered.
Date of transfer
2. Where a consultant subject to this Schedule gave a formal commitment to the
new contract on or before 31 October 2003, pay increases under the new
contract will be backdated to 1 April 2003. Where a consultant gave a formal
commitment to the new contract between 31 October 2003 and 31 March 2004,
pay increases will be backdated by three months from the date on which the
commitment was given. In each case, backdating will be conditional upon a job
plan being agreed within three months, except where this deadline was not met
for reasons beyond the consultants control. Consultants may choose any
shorter period of backdating if they so wish. Where a consultant gives a
commitment to the contract after 1 April 2004, there will be no backdating. A
formal commitment for these purposes is not legally binding, but consultants
are expected to enter into such a commitment in good faith and in the full
expectation of taking up the new contract.
3. For consultants subject to this Schedule, progression through pay thresholds

(see below) will be on the anniversary of transfer to these Terms and
Conditions of Service, subject to being continuously employed in the NHS. For
consultants who give a formal commitment to the new contract before 1 April
2004 and who therefore received backdated increases in pay, the date of
transfer will be regarded as the date to which increases in pay are backdated.
For other consultants subject to this Schedule, the date of transfer will be the
date on which the consultant first starts work under these Terms and
Conditions.
Pay Uplifts
4. Increases to pay threshold values may be determined from time to time
following the recommendations of the Review Body on Doctors and Dentists
Remuneration.
Definition of seniority
5. Both salary on commencement and eligibility for subsequent pay thresholds will
depend on a consultants seniority (see Annex A, Table 1). For these
purposes, seniority is to be measured as the sum of the number of whole years
completed as an NHS consultant, plus the point on the salary scale when
appointed (on a scale of 1 to 5), plus any additional credited seniority (in whole
years) to reflect non-NHS consultant level experience or flexible training (see
below). For the avoidance of doubt, seniority may only accrue during an
absence when on an employment break scheme to reflect the gaining of
approved non-NHS consultant level experience.6
6. The employing organisation will credit appropriate additional seniority to reflect

any consultant level experience gained outwith the NHS consultant system,
27
taking care to ensure that there is no double counting of this and any additional
seniority granted at appointment by way of a higher point on the salary scale.
7. Where a consultants training has been lengthened by virtue of being in a

flexible training scheme or because of undergoing dual qualification, the
employing organisation will, where necessary, credit appropriate additional
seniority to ensure that the consultant is not prevented from reaching the pay
threshold they would have attained had they trained on a full time or single
qualification basis (e.g. training extended by two years counts as the equivalent
of two years seniority as a consultant on first appointment as a consultant).
See separate guidance on part time contracts.
Basic pay on commencement

8. On commencement, and subject to the provisions on pay protection set out
below, the value of basic salary and of payments for any additional
Programmed Activities will:
for full-time consultants who have previously held a whole-time NHS
consultant contract and full-time consultants who have previously held a
maximum part-time NHS consultant contract be as referred to by Annex
A, Note 1;
for part-time consultants be pro rata to the levels referred to by Annex A,
Note 1, based on the number of agreed weekly Programmed Activities in
the consultants Job Plan as a proportion of the standard ten Programmed
Activities for full-time consultants.7,8
9. Where a consultant holds discretionary points or a local clinical excellence

award, there will be a pro rata increase in the payment for an additional
Programmed Activity, compared with the rates referred to by Annex A, Note 1.
Where a consultant holds a distinction award or a higher clinical excellence
award, the pro rata increase in the payment for an additional Programmed
Activity will be based on the maximum level of discretionary points or local
clinical excellence awards as the case may be.
10. The annual rate for an additional Programmed Activity will be 10% of basic
salary, where basic salary includes the pay thresholds and any discretionary
points or local clinical excellence awards.9
Pay protection
11. There will be no financial detriment to any consultants for whom the combined
total of their basic pay and any on-call availability supplement (as assessed
under the provisions in Schedule 16) would otherwise be less than the
combined total of their basic pay and any intensity supplement under their
previous NHS contract and terms and conditions. For consultants who
transferred to these Terms and Conditions in 2003/04, there will be full
protection for one year, i.e. taking account of annual pay uplift for 2004/05 for
consultants on the previous national terms and conditions. After this date,
protection will be on a mark-time basis (i.e. until the new salary exceeds the
salary at the point of transfer).10
12. This is provided the consultant continues to undertake the same level of duties
and responsibilities and on-call commitments and remains employed by the
same NHS organisation or equivalent successor organisation.
28
Pay thresholds
13. Consultants will become eligible for pay thresholds at the intervals set out in
Annex A, Table 1 on the anniversary of transfer to the contract (see paragraph
3 above).
14. The value of pay thresholds for full-time consultants who have previously held
a whole-time NHS consultant contract will be as referred to by Annex A, Note
1.
15. The value of pay thresholds for part-time consultants will be pro rata to the
levels referred to by Annex A, Note 1, based on the number of agreed weekly
Programmed Activities in the consultants Job Plan as a proportion of the ten
standard Programmed Activities for full-time consultants.
16. Unallocated.
Unallocated 11
17. .
29
Annex A12, 34
Note 1: Pay rates for consultants appointed before 31 October 2003 can be found in
the latest Pay Circular [see Annex A of the Pay Circular: Section 2: Annex A] which is
available on the NHS Employers website at www.nhsemployers.org/pay-
conditions/pay-conditions-2339.cfm
Table 1: Pay progression for consultants appointed before 31 October 2003
Seniority Pay scale

Years after transfer before Pay
at
threshold level changes threshold
transfer
30+ On transfer to new contract
1 year after transfer 7 MC71
2 years after transfer 8
21-29 On transfer to new contract
20 On transfer to new contract
2 years after transfer 6 MC67
3 years on transfer 6 MC64
4 years on transfer 7
8 years on transfer 8
30
1 year after transfer * MC55
31
*For consultants with seniority of 1,3 or 5 years on transition, the first pay threshold is
for transitional purposes
32
Schedule 14 Basic salary and payment for additional
programmed activities for consultants appointed
after 31 October 200343
1. This Schedule applies to all those whose first appointment as a NHS consultant
is on or after 31 October 2003. For these purposes, the date of appointment
will be regarded as the date on which the consultant post was offered. There
are eight pay thresholds for consultants first appointed on or after 31 October
2003, the value of which is set out in a Pay Circular (see Annex B: Note 1).
Subject to the provisions in Schedule 15, there is eligibility for annual
progression up to threshold 5; whilst eligibility for progression through the next
three thresholds shall occur at five-yearly intervals.
2. For consultants subject to this Schedule, progression through pay thresholds

(see below) will be on the anniversary of appointment, subject to being
continuously employed in the NHS. For these purposes, the date of
appointment will be regarded as the date on which the consultant first started
work as a consultant subject to these Terms and Conditions.
Pay Uplifts
3. Increases to pay threshold values may be determined from time to time
following the recommendations of the Review Body on Doctors and Dentists
Remuneration.
Basic pay and pay thresholds

4. On commencement, basic salary and payments for any additional
Programmed Activities will be the first of the thresholds referred to by Annex
B, Note 1, subject to paragraphs 5 and 6 below.
5. Basic salary on commencement will be set at a higher threshold to reflect any

approved consultant-level experience that a consultant has gained. For the
avoidance of doubt, seniority may only accrue during an absence on an
employment break scheme to reflect the gaining of approved non-NHS
consultant level experience.13
6. Where a consultants training has been lengthened by virtue of being in a

flexible training scheme or because of undergoing dual qualification, the
employing organisation will, where necessary, set basic salary on
commencement at a higher threshold to ensure that the consultant is not
prevented from reaching the pay threshold they would have attained had they
trained on a full time or single qualification basis (e.g. training extended by two
years counts as the equivalent of two years consultant service where a
consultant would not otherwise be able to reach the same pay threshold).14
7. The annual rate for an additional Programmed Activity will be 10% of basic
salary, where basic salary includes the pay thresholds and any local clinical
excellence awards.15
8. Consultants will become eligible for additional pay thresholds at the intervals in
Annex B, Table 1 on the anniversary of appointment (see paragraph 2 above).
9. The value of pay thresholds for part-time consultants will be pro rata to the
levels referred to by Annex B, Note 1, based on the number of agreed weekly
33
Programmed Activities in the consultants Job Plan as a proportion of the ten
standard Programmed Activities for full-time consultants.
10. Where a consultant holds a local clinical excellence award, there will be a pro
rata increase in the payment for an additional Programmed Activity, compared
with the rates referred to by Annex B, Note 1 . Where a consultant holds a
higher clinical excellence award, the pro rata increase in the payment for an
additional Programmed Activity will be based on the maximum level of local
clinical excellence awards.
11. Where Associate Specialists have been paid in their previous regular
employment at a basic salary, including any discretionary points, higher or
equal to the rate at which they would (were it not for this provision) be paid on
taking up their new Consultant appointment, then their starting salary in the
new appointment shall be fixed at the threshold in the scale next above that
previous rate.57
34
Annex B16, 35
Note 1: Pay rates for consultants appointed on or after 31 October 2003 can be
found in the latest Pay Circular [see Annex A of the Pay Circular: Section 2: Annex B]
which is available on the NHS Employers website at www.nhsemployers.org/pay-
conditions/pay-conditions-2339.cfm
Table 1: Pay progression for consultants appointed on or after 31 October 2003
Threshold Years Period before Payroll point

completed as eligibility for next
a consultant threshold
1 0 1 year MC72 Point 00
5 4 5 years MC72 Point 04
5 4 years MC72 Point 05
8 1 year MC72 Point 08
8 19 - MC72 Point 19
35
36
Schedule 15 Pay thresholds
Criteria for pay thresholds
1. Following the annual Job Plan review, the clinical manager who has conducted
the Job Plan review will report the outcome, via the Medical Director, to the
Chief Executive and copied to the consultant and the Chief Executive of any
other NHS organisation with which the consultant holds a contract of
employment, setting out for the purposes of decisions on pay thresholds
whether the consultant has:
made every reasonable effort to meet the time and service commitments
in the Job Plan;
participated satisfactorily in the appraisal process;
participated satisfactorily in reviewing the Job Plan and setting personal
objectives;
met the personal objectives in the Job Plan, or where this is not achieved
for reasons beyond the consultants control, made every reasonable effort
to do so;
worked towards any changes identified in the last Job Plan review as
being necessary to support achievement of the employing organisations
objectives;
taken up any offer to undertake additional Programmed Activities that the
employing organisation has made to the consultant in accordance with
Schedule 6 of these Terms and Conditions;
met the standards of conduct governing the relationship between private
practice and NHS commitments set out in Schedule 9.
2. The Chief Executive, informed by the Medical Directors recommendation, will

subsequently decide each year whether the consultant has met the criteria.
3. Where one or more of the criteria are not achieved in any year, the Chief
Executive will have the discretion to decide where appropriate, for instance
because of personal illness, that the consultant should nonetheless be
regarded as having met the criteria for that year.
4. Consultants should not be penalised if objectives have not been met for
reasons beyond their control. Employers and consultants will be expected to
identify problems (affecting the likelihood of meeting objectives) as they
emerge, rather than wait until the job plan review.
5. It will be the norm for consultants to achieve pay progression. Pay progression
may only be deferred where the consultant has not met the specified criteria at
paragraph 1 of this Schedule. Employing organisations cannot introduce any
new criteria. For instance, pay progression cannot be withheld or delayed on
the grounds of the employing organisations financial position. Nor would it be
acceptable for NHS organisations to use any system of quotas for pay
progression.
6. A consultant has the right of appeal against a decision by the Chief Executive
that he or she has not met the criteria in respect of any given year. In the event
of an appeal, it will be the responsibility of the employing organisation to show
37
why this decision was taken. The appeal process is at Schedule 4 of the
Terms and Conditions.
Process for award of pay thresholds

7. When a consultant becomes eligible for a pay threshold by virtue of fulfilling the
required number of years service in Schedule 13 or Schedule 14 of the Terms
and Conditions, he or she will receive that pay threshold provided that the Chief
Executive agrees that they have met the criteria above in each year since the
award of the previous threshold or, in the case of a consultants first pay
threshold, since the commencement of a contract subject to these terms and
conditions.
8. Where the Chief Executive has decided in any one year that a consultant has
not met the necessary criteria, the employing organisation will defer the award
of the appropriate pay threshold for one year beyond the date on which they
would otherwise have received the threshold. Provided the Chief Executive
decides that a consultant has met the criteria in the intervening year, he or she
will receive that pay threshold from the start of the following year.
38
Schedule 16 Pay supplements32
On-call availability supplement
1. If a consultant is required to participate in an on-call rota, he or she shall be
paid a supplement in addition to basic salary, in recognition of his or her
availability to work during on-call periods. The availability supplement will be
paid at the appropriate rate set out in Table 1 below.
2. The level of supplement will depend on both
the contribution of the consultant to the on-call rota and

the category of the consultants on-call duties.
Contribution to the rota

3. Full-time consultants shall receive the availability supplement as specified in
Table 1 below. Part-time consultants, whose contribution when on-call is the
same as that of full-time consultants on the same rota, shall receive the
appropriate percentage of the equivalent full-time salary. The contribution of
any consultant to the rota will be determined without regard to any alternative
arrangements that the consultant may make with colleagues to provide on-call
cover.
Category of on-call duties

4. The employing organisation will determine the category of the consultants
on-call duties for these purposes by making a prospective assessment of the
typical nature of the response that the consultant is likely to have to undertake
when called during an on-call period. This assessment will take into account
the nature of the calls that the consultant typically receives whilst on-call. The
two categories are:
Category A: this applies where the consultant is typically required to
return immediately to site when called or has to undertake interventions
with a similar level of complexity to those that would normally be carried
out on site, such as telemedicine or complex telephone consultations;
Category B: this applies where the consultant can typically respond by
giving telephone advice and/or by returning to work later.
5 Where there is a change to the consultants contribution to the rota or the

categorisation of the consultants on-call duties, the level of the availability
supplement will be amended on a prospective basis. Where this results in a
reduction in the level of availability supplement, there will be no protection
arrangements in relation to previous entitlements. The consultant is entitled to
challenge any changes to the assessment of on-call duties through the Job
Planning process.
6. The availability supplement does not alter the amount of basic salary for any
other purpose or calculation.
7. Basic salary, for these purposes, will include pay thresholds. It will exclude any
Clinical Excellence Awards, Discretionary Points, Distinction Awards, London
Weighting Allowance, on-call availability supplement, recruitment or retention
premium, and any other fees, allowances or supplements.
39
Table 1
On-call availability supplement
Value of availability supplement as a percentage of

Frequency of rota full-time basic salary
commitment
Category A Category B
High frequency:
8.0% 3.0%
1 in 1 to 1 in 4
Medium frequency:
5.0% 2.0%
1 in 5 to 1 in 8
Low frequency:
3.0% 1.0%
1 in 9 or less frequent
8. Unallocated.44
London Weighting Allowance

9. Consultants whose place of work (i.e. where his or her principal duties lie) is
within the boundaries of the former health authorities designated by paragraph
5, or in one of the units designated by paragraph 10, of section 56 of the
General Council Conditions of Service (or subsequent replacement) shall be
paid London Weighting at the rate specified from time to time in Pay Circulars
advising national rates of pay.45
10. Consultants whose place of work (i.e. where his or her principal duties lie) is
within the boundaries of the former health authorities designated by paragraph
12 of section 56 of the General Council Conditions of Service (or subsequent
replacement) shall be paid London Weighting at the rate for the Fringe Zone
specified from time to time in Pay Circulars advising national rates of pay,
unless he or she is employed at a unit described in paragraph 9 above.46
11. A reduced rate of London Weighting is payable to resident staff who receive
free accommodation.47
12. Part time consultants shall receive the appropriate proportion of London
Weighting.
Recruitment and retention premia

13. An employing organisation may under certain circumstances decide to award a
recruitment or a retention premium in addition to basic salary. This may be
paid either as a single sum, or on recurrent basis but for a time-limited period.
If the latter, the period in question will not typically last for more than four years.
14. Employing organisations will determine the value of any such premium and
may adjust its value from time to time to take account of changing
circumstances. The value of the premium will not typically exceed 30 per cent
of the normal starting salary for a consultant post.
15. Before making such an award, employing organisations will:

set out evidence of difficulties in recruiting and retaining consultants in the
particular specialty, or post in question;
set out evidence that they have adequately considered and tried non-pay
solutions to such difficulties;
40
consult with other NHS employing organisations and other appropriate
bodies such as the Strategic Health Authority for the area in question.
Other payments and allowances

16. A consultant may be entitled to certain other payments and allowances at the
discretion of the employing organisation.48
Directors of Public Health

17. Directors of Public Health will be entitled to supplements in addition to basic
salary (in line with the provisions in Schedule 13 or Schedule 14) within the
range as specified from time to time in Pay Circulars advising national rates of
pay. These supplements will depend on the band within which their post falls
and the weight of the post as assessed by their employing organisation. Band
A applies to regional posts, irrespective of population. The definition of the
relevant bands is set out below:
Band A: Director of Public Health Regional Posts

Band B: Director of Public Health population over 450,000
Band C: Director of Public Health population 250,000 - 449,999
Band D: Director of Public Health population 50,000 - 249,99949
18. Supplements shall be an element of remuneration and shall be pensionable.50
19. Population shall be reviewed annually at 1 April. The relevant population for
this purpose shall be the Registrar Generals estimate of the home population
for the employing organisation at the previous 30 June.
20. If the home population for the employing organisation increases to a higher
population band for one year only, this shall have no effect on the minimum
supplement. If the rise to a higher population band is confirmed by the next
years estimate, a review of the supplement payable should be completed
within six months. Payment of any increased supplement following such a
review shall be made with retrospective effect from 1 April of the previous year.
21. If the home population for the employing organisation falls to a lower population
band for one year only, this shall have no effect on the minimum supplement.
If the fall in population is confirmed by the next years estimate, a review of the
supplement payable should be completed within six months. Where this would
result in a reduction in the value of the supplement, a Director of Public Health
shall retain the cash value of his or her existing supplement for so long as that
remains more favourable.51
41
Schedule 17 Pension arrangements52
1. The consultant will be eligible for membership of a NHS Pension Scheme, the
provisions of which are set out in the NHS Pension Scheme Regulations 1995
(as amended).
2. The following will be pensionable in the NHS Pension Scheme:

the consultants basic salary (up to ten Programmed Activities), including
pay thresholds;
enhancements to basic salary by way of any discretionary points,
distinction awards or clinical excellence awards;
any on-call availability supplement;
any London Weighting Allowance; and
fees for domiciliary visits not undertaken during Programmed Activities.
3. The following will not be pensionable in the NHS Pension Scheme:

travelling, subsistence, and other expenses paid as a consequence of the
consultants work for the employing organisation or the wider NHS;
any recruitment or retention premium;
any payments for additional Programmed Activities; and
any payments for work the consultant undertakes for Local Authorities,
subject to local agreements to the contrary.
Removal or downgrading of a distinction award or clinical excellence award

4. If a distinction award or clinical excellence award is removed or downgraded,
the consultant will normally continue to be paid the value of the award he or
she received at the time this decision was made. This will be taken into
account in the calculation of the consultants pension in the normal way.
5. In exceptional circumstances, a consultant may lose the value of the award as

well as the award itself. This may affect the value of the consultants pension
depending on the date on which this deduction was made.
Mental health officer status

6. There will be no effect on the Mental Health Officer status of consultants
transferring to these terms of service.
42
Schedule 18 Leave and public holidays
A. Annual leave and public holidays
Annual leave
1. Consultants are entitled to annual leave at the following rates per year,
exclusive of public holidays and extra statutory days:
Number of years of completed service as a

consultant
Year Up to seven years Seven or more years
Until 31 March 2004 Six weeks Six weeks
1 April 2004 31 March 2005 Six weeks Six weeks + one day
From 1 April 2005 Six weeks Six weeks + two days
2. The leave year runs from the anniversary date of the consultants appointment.,
or adjusted to a common start date in force in that employment. No detriment
to the consultant will arise from the leave year adjustment.
3. Annual leave should be discussed at the annual Job Plan review. Dates for
annual leave and the arrangements for the consultants work to be done in his
or her absence should be incorporated into the agreed Job Plan, or
alternatively agreed at least two months in advance, if possible. Subject
however to suitable arrangements having been made, consultants may take up
to two days of their annual leave without seeking formal permission provided
that they give notification beforehand.
Public holidays
4. The leave entitlements of consultants in regular appointment are additional to
eight public holidays and two statutory holidays or days in lieu thereof. The two
statutory days may, by local agreement, be converted to a period of annual
leave.17
5. In addition, a consultant who in the course of his or her duty was required to be
present in hospital or other place of work between the hours of midnight and
9am on statutory or public holidays should receive a day off in lieu.
Carry over of annual leave

6. Annual leave may be carried over subject to Section 1, paragraphs 10-14 of the
General Council Conditions of Service.
7. The employing organisation will not ordinarily make payment in lieu of annual
leave.
Sickness during annual leave

8. If a consultant falls sick during annual leave and produces a statement to that
effect, he or she will be regarded as being on sick leave from the date of the
statement. A self certificate may cover days 1 to 7 of the period of sickness.
The consultant must obtain a medical certificate for subsequent days. Further
annual leave will be suspended from the date of the first statement.
43
B. Professional and study leave
Definition
9. Professional and study leave includes:
study, usually but not exclusively or necessarily on a course or
programme;
research;
teaching;
examining or taking examinations;
visiting clinics and attending professional conferences;
training.
Proposing professional or study leave

10. A consultant may be allowed professional or study leave for approved
postgraduate purposes.
Conditions
11. Any grant of leave is subject to the need to maintain NHS services.
12. Where leave with pay is granted, the consultant must not undertake any other
paid work during the leave period without the employing organisations prior
permission.
Period of leave
13. Subject to the conditions in paragraph 16, professional or study leave will
normally be granted to the maximum extent consistent with maintaining
essential services in accordance with the recommended standards, or may
exceptionally be granted under the provisions of paragraphs 14 and 16. The
recommended standard for consultants is leave with pay and expenses within a
maximum of thirty days (including off-duty days falling within the period of
leave) in any period of three years for professional purposes within the United
Kingdom.
Additional periods of professional and study leave in the United Kingdom

14. Authorities may at their discretion grant professional or study leave in the
United Kingdom above the period recommended in paragraph 13 with or
without pay and with or without expenses or with some proportion thereof.
Professional and study leave outside the United Kingdom

15. Authorities may at their discretion grant professional or study leave outside the
United Kingdom with or without pay and with or without expenses or with any
proportion thereof.
Conditions
16. The following conditions shall apply:
(i) where a consultant is employed by more than one NHS organisation, the
leave and the purpose for which it is required must be approved by all the
organisations concerned;
(ii) where leave with pay is granted, the consultant must not undertake any
remunerative work without the special permission of the leave-granting
organisation;
44
(iii) where an application is made under paragraphs 14 and 15 for a period of
leave with pay, and this exceeds three weeks, it shall be open to the leave-
granting organisation to require that one half of the excess over three
weeks shall be counted against annual leave entitlement, the carry forward
or anticipation of annual leave within a maximum of three weeks being
permitted for this purpose.
C. Sabbaticals
17. A consultant may apply for sabbatical leave in accordance with the employing
organisations current arrangements. Any proposal for sabbatical leave should
be made before the annual appraisal and considered in the annual Job Plan
review.
D. Sick leave
Section D is supplemented by Annex Z of the NHS Staff Handbook which sets out a
framework to support employers and staff in the management of sickness absence
and manage the risk of premature and unnecessary ill health retirements.
Scale of allowances
18. A consultant absent from duty owing to illness (including injury or other
disability) shall, subject to the provisions of paragraphs 2 to 15, be entitled to
receive an allowance in accordance with the following table:
Table1: Consultant sick leave entitlement
During the first year of service One month's full pay and (after
completing four months' service) two
months' half pay.
During the second year of service Two months' full pay and two months'
half pay.
During the third year of service Four months' full pay and four months'
half pay.
During the fourth and fifth years of Five months' full pay and five months'
service half pay
After completing five years of service Six months' full pay and six months' half
pay.
19. The employer shall have discretion to extend a consultants sick leave
entitlement.
20. To aid rehabilitation the employer has discretion to allow a consultant to return
to work on reduced hours or to be encouraged to work from home without loss
of pay to aid rehabilitation. Any such arrangements need to be consistent with
statutory sick pay rules.
Calculation of allowances
21. The rate of allowance, and the period for which it is to be paid in respect of any
period of absence due to illness, shall be ascertained by deducting from the
period of benefit (under paragraph 18) appropriate to the consultant's service
on the first day of absence the aggregate for the period of absence due to
45
illness during the twelve months immediately preceding the first day of
absence. In aggregating the periods of absence, no account shall be taken of:
unpaid sick leave; or
injuries or diseases sustained to members of staff in the actual discharge of their

duties through no fault of their own; or
injury resulting from a crime of violence not sustained on duty but connected with
or arising from the consultant's employment or profession, where the injury has
been the subject of payment by the Criminal Injuries Compensation Authority; or
due to injury as at sub-paragraph (ii) above which has not been the subject of
payment by the Authority on grounds that it has not given rise to more than three
weeks' loss of earnings, or was not one for which compensation above the
minimum would arise.
22. The employer may at its discretion also take no account of the whole or part of
the periods of absence due to injury (not on duty) resulting from a crime of
violence not arising from or connected with the consultant's employment or
profession.
Previous qualifying service

23. For the purpose of ascertaining the appropriate allowance of paid sick leave
under paragraph 18, previous qualifying service shall be determined in
accordance with a consultants statutory rights and all periods of service,
without any break of twelve months or more (unless undertaking voluntary
service), with a National Health Service employer shall be aggregated.
Limitation of allowance when insurance or other benefits are payable

24. The sick pay paid to a consultant when added to any statutory sickness,
injuries or compensation benefits, including any allowances for adult or child
dependants, must not exceed full pay.
Submission of doctor's statements

25. A consultant who is incapable of doing his or her normal work because of
illness shall immediately notify the employer according to the employers
procedures.
26. Any absence of more than seven days shall be certified by a doctor other than
the sick consultant. Statements shall be submitted according to the employers
procedures.
Accident due to sport or negligence

27. An allowance shall not normally be paid in a case of accident due to active
participation in sport as a profession, or in a case in which contributory
negligence is proved, unless the employer decides otherwise.
Injury sustained on duty

28. (i) An absence due to injury sustained by a consultant in the actual discharge
of his or her duty, for which the consultant was not liable, shall not be recorded
for the purposes of these provisions.
46
(ii) The injury Allowance provisions will apply as set out in Section 22 of the
NHS Terms and Conditions of Service Handbook, and should be read
alongside the accompanying guidance issued by NHS Employers.59
Recovering of damages from third party

29. A consultant who is absent as a result of an accident is not entitled to sick pay
if damages are received from a third party. Employers may agree to advance to
a consultant a loan, not exceeding the amount of sick pay under these
provisions, providing the consultant repays to the employer when damages are
received, the full amount or portion thereof corresponding to the amount in
respect of loss of remuneration including the damages received. Once received
the absence shall not be taken into account for the purposes of the scale set
out in Table 1.
Medical examination
30. The employer may at any time require a consultant who is unable to perform
his or her duties as a consequence of illness to submit to an examination by a
medical practitioner nominated by the employer. Any expense incurred in
connection with such an examination shall be met by the employer.
Termination of employment
31. After investigation, consultation and consideration of other alternative posts,
and where there is no reasonable prospect of the consultant returning to work,
employers will have the option to terminate employment before the employee
has reached the end of the contractual period of sick leave, provided that the
consultant will receive his or her entitlement in accordance with Table 1.
Procedures and payment when injuries are connected with other insured
employment
32. Notification procedures and payment of sick pay when injuries are connected
with other insured employment will be for local determination.
E. Special leave with or without pay
33. Special leave for any circumstances may be granted (with or without pay) at
the discretion of the employer. Where a consultant is required to attend court
as a witness, as a result of the normal course of delivering his or her NHS
duties, such attendance will be classified as Contractual and Consequential
Services.18
F. Maternity leave and pay
34. The provisions of Schedule 24 shall apply.
35. Unallocated.18
47
Schedule 19 Termination of employment
Period of notice
1. Where termination of employment is necessary, an employing organisation will
give a consultant three months notice, in writing.
2. Consultants are required to give their employing organisation three months

written notice if they wish to terminate their employment.
3. Shorter or longer notice may apply where agreed between both parties in
writing and signed by both.
Grounds for termination of employment

4. A consultants employment may be terminated for the following reasons:
conduct
capability
redundancy
failure to hold or maintain a requisite qualification, registration or licence
to practice
in order to comply with statute or other statutory regulation
where there is some other substantial reason to do so in a particular case.
5. Should the application of any disciplinary or capability procedures result in the

decision to terminate a consultants contract of employment, he or she will be
entitled to an appeal.
6. In cases where employment is terminated, a consultant may be required to

work his or her notice, or, if the employing organisation considers it more
appropriate, a consultant may be paid in lieu of notice, or paid through the
notice period but not be required to attend work.53
7. In cases of gross misconduct, gross negligence, or where a consultants

registration as a medical practitioner (and/or their registration as a dental
practitioner) has been removed or has lapsed without good reason,
employment may be terminated without notice.
Termination of employment upon re-organisation

8. Where a re-organisation of local health services involves displacement of, or
significant disturbance to, the services provided by a consultant, the employing
organisation will use reasonable endeavours to render effective assistance to
the consultant with a view to his or her obtaining comparable work elsewhere in
the NHS.
Termination of employment by redundancy

9. If a consultants employment is terminated because of redundancy within the
meaning of section 39 of the Employment Rights Act 1996, or in the
circumstances described in Schedule 26, then provided that he or she has two
years or more continuous service, entitlement will be in accordance with
Schedule 26.28
48
Schedule 20 Incorporated general council conditions of
service36
This Schedule lists those General Whitley Council (or successor body)
agreements which apply under the contract except where otherwise indicated
in these Terms and Conditions.
GWC Subject
Section
S1. Annual leave entitlement
S2. Statutory and public holidays
S7.A General Statement
S7.B Recruitment, promotion and staff development
S7.C Dignity at work
S22. Subsistence allowances
S23. Travelling expenses
S26. Removal expenses and associated provisions
S38. Facilities for staff organisations
S39. Joint consultation machinery
S41. Health awareness for NHS staff
S46. Payment of superannuation and compensation benefits on premature

retirement
S48. Protection of pay and conditions of service
S52. Position of employees elected to parliament
S53. Membership of local authorities
S54. Payment of annual salaries
S55. Preparation for retirement
S56. London weighting

(only paragraphs 4, 10 to 14 and 18 to 20 thereof apply)
S57. Statutory sick pay: qualifying days
S59. NHS Trusts - continuity of service
S61. Annual leave and sick pay entitlements on re-entry and entry into NHS
employment
49
NB Please note that Maternity Leave and Pay arrangements are now covered in
temporary Schedule 24.19
NB Information on the new doctors and dentists disciplinary framework can be

found at: 19
http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndG
uidance/PublicationsPAmpGBrowsableDocument/fs/en?CONTENT_ID=4103418&ch
k=UVbdwG
NB Please note that Redundancy Pay arrangements are now covered in

Temporary Schedule 26. 29
NB Please note that Caring for Children and Adults is now covered by Temporary
Schedule 27.
NB Please note that Flexible Working Arrangements is now covered by Temporary

Schedule 28.
NB Please note that Balancing Work and Personal Life is now covered by
Temporary Schedule 29.
50
Schedule 21 Model provisions for expenses NHS
consultants
These model provisions are designed to serve as the basis for agreements
about the payment of consultant expenses for medical consultants employed
by the NHS or contracted on an honorary basis. NHS employers and
consultants may agree alternative provisions.
General
1. Travelling, subsistence, and other expenses incurred in the service of the

employer shall be reimbursed to meet actual costs. Expenses do not form part of
a consultants pay and are not pensionable.
Submission of claims
2. In preparing claims, consultants shall indicate adequately the nature of the
expenses involved and submit valid receipts; claims shall be submitted normally
at intervals of not more than one month, and as soon as possible after the end of
the period to which the claim relates.
Travelling expenses and mileage allowances

3. The provisions of Section 23 (except paragraphs 2.4 and 4) of the General
Council Conditions of Service shall apply. In these provisions "principal place of
work" shall be understood to mean "the hospital or other base from which the
consultant conducts his or her main duties. Where a consultant has a joint
contract with more than one employing organisation, the term "principal place of
work" shall be interpreted as meaning the base from which the consultant
conducts his or her main duties within that joint contract, irrespective of
employing organisation.
Mileage allowances payable

4. Except where a consultant has been allocated a Lease Car (paragraphs 32 to 54
and subject to paragraph 35 of these provisions) mileage allowances shall be
payable in accordance with the rates specified at paragraphs 15 to 26 of these
provisions, as appropriate, where consultants use their private vehicle for any
official journey on behalf of their employing organisation, including travel in
connection with domiciliary consultations.
5. No allowance shall be payable for their normal daily journey between their home
and their principal place of work, except as provided for in paragraphs 6 to 11.
Emergency visits
6. Consultants called out in an emergency shall be entitled to mileage allowance in
respect of any journey they are required to undertake, including the distance
between their home and principal place of work.
Home-to- principal place of work mileage

Official journeys beginning at home
7. Mileage allowance will be paid for official journeys on behalf of the employing
organisation where consultants travel by private car between their home and
places other than their principal place of work, subject to a maximum of the
51
distance between the consultant's principal place of work and the place visited,
plus ten miles, for each single journey (twenty miles for a return journey).
8. For consultants in public health medicine, for official journeys between 6pm and
8am and on Saturdays, Sundays, statutory and public holidays only between 8am
and 6pm, the base for the calculation of mileage allowance shall be the doctors
own home.
Subsequent official journeys

9. In addition, consultants may claim mileage allowance for one return journey daily
between their home and their principal place of work, up to a maximum of ten
miles in each direction, on days when they subsequently use their car for an
official journey.
Liability to make emergency visits

10. Consultants with commitments under the same contract to visit more than one
place of work which includes a liability to make emergency visits to subsidiary
hospitals, other institutions, or domiciliary visits, may, if the employing
organisation decides that their liability is so extensive as to make it desirable that
their car should always be available at their principal place of work, claim mileage
allowances for normal daily journeys between their home and principal place of
work up to a maximum of ten miles in each direction.
Scattered hospitals
11. Where, in exceptional circumstances, consultants are required by their employing
organisation, as a condition of their contract, to live within a specified area at a
distance of more than ten miles by road from their principal place of work in order
to provide adequate emergency cover to a group of widely scattered hospitals or
other institutions, mileage allowance at the approved rate shall be paid for the
whole of the journey between their home and their principal place of work.
Part-time consultants
12. In the case of part-time consultants to whom paragraphs 7 to 11 do not apply,
journeys between their place of residence and any place of work where they are
employed, other than their principal place of work, shall be regarded as a journey
in the service of the employing organisation, provided that no expenses shall be
allowed for any such journey or part of such journey which would have been
undertaken by the consultant, irrespective of their duties for the employer.
13. Where a part-time consultant travels between their place of residence and their
principal place of work before and/or after an official journey, expenses shall be
payable for the whole distance, provided that, for journeys to and from their
principal place of work, no expenses shall be paid for any distance exceeding ten
miles each way, unless the circumstances warrant exceptional treatment.
Locum Consultants58
14. Where a locum consultant travels between his or her home (or temporary
accommodation) and principal place of work, expenses shall be payable in
respect of any distance by which the journey exceeds 10 miles.
Rates of mileage allowance: regular user allowances

15. Allowances at regular user rates shall be paid to consultants who :
52
(i) are classified by the employing organisation as regular or essential
users and choose not, or are unable, to avail themselves of a Lease
Car in accordance with paragraphs 32 to 40; or
(ii) are new appointees to whom the employing organisation has deemed
it uneconomic, or is unable, to offer a Lease Car in accordance with
paragraphs 32 to 40; and
(iii) are required by their employing organisation to use their own car on
NHS business and, in so doing, either:
(a) travel an average of more than 3,500 miles a year; or
(b) travel an average of at least 1,250 miles a year, and:
(c) necessarily use their car on an average of three days a week; or
(d) spend an average of at least 50% of their time on such travel,

including the duties performed during the visits; or
(iv) are consultants who are classified as essential users.
Essential users allowance

16. Essential users are consultants who:
(i) travel on average at least 1,250 miles (other than normal travel
between their home or their practice premises and their principal place
of work) each year; and
(ii) either have ultimate clinical responsibility, or on-call responsibility

normally controlled by a rota system, for the diagnosis and treatment
of patients in hospital with emergency conditions which require them
to be immediately available for recall; and are expected to be recalled
to hospital in emergency at an average rate (taken over the year, but
excluding period of leave) of twice or more during a working week;
(iii) or whose duties require them to pay frequent visits to places away
from their principal place of work (eg. to clinics, schools, residential
establishments and other places, for instance, in connection with the
control of infectious diseases and food poisoning), or who are liable to
be called out in an emergency in connection with statutory duties
relating to the control of communicable disease and food poisoning or
the compulsory removal to suitable premises of persons in need of
care and attention.
Change in circumstances
17. If there is a change in a consultant's duties, or if the official mileage falls below
that on which a regular or essential user classification was based and which is
likely to continue, the application to the consultant of the regular user agreement
should be reconsidered. Any decrease in the annual official mileage or the
frequency of travel, etc. which is attributable to circumstances such as prolonged
sick leave or the temporary closure of one place of duty should be ignored for this
purpose.
53
Non-Classification as regular user
18. Where an employing organisation does not consider that a consultant, other than
one to whom paragraph 35 of these provisions applies, should be classified as a
regular or essential user, and if this gives rise to any serious difficulty, the
consultant shall have recourse to local grievance procedures.
Payment of lump sums

19. Payment of the annual lump sum allowance shall be made in equal monthly
instalments over a period from 1 April in any year to 31 March in the succeeding
year.
20. In the case of a consultant who takes up an appointment with an employing

organisation or leaves the employment of his or her employing organisation after
1 April in any year, allowances shall be paid pro rata. The calculation of the
mileage allowance should thus be in accordance with the following procedure:
(i) The mileage allowance to be paid at the higher rate would, at 9,000
miles per annum, be equivalent to 750 miles per month of service. The
excess over 750 miles per month of service would be paid at the
intermediate, and, if appropriate, the lower rate. For example, where
the total service in the period 1 April in any year to 31 March in the
succeeding year is five months, then up to 3,750 miles would be paid
at the higher rate and any excess at the intermediate, and, if
appropriate, the lower rate. Similarly, the lump sum should be divided
into twelve monthly payments.
(ii) When a consultant leaves the employment of an employing

organisation, a calculation shall be made in respect of his or her
entitlement for the portion of the year served with the employing
organisation and any adjustments made thereafter.
Part months of service

21. Part months of service shall be regarded as complete months for the purposes of
paragraph 19. However, a regular user who leaves the service of one employing
organisation and enters the employment of another during the same month shall
receive only one lump sum instalment for that month, payable by the former
Cars out of use

22. When a consultant entitled to the regular user allowance does not use his or her
car as a result of a mechanical defect or absence through illness:
(i) the lump sum payment should be paid for the remainder of the month
in which the car was out of use and for a further three months
thereafter. For the following three months, payment should be made at
the rate of 50% of the lump sum payment. No further payments should
be made if the car is out of use for six months or longer;
(ii) during the period when the car is "off the road" for repairs, out-of-
pocket expenses in respect of travel by other forms of transport should
be borne by the employing organisation, in accordance with the
provisions of paragraph 2 of Section 23 of the General Council
Conditions of Service.
54
Standard mileage rates
23. Mileage allowances at standard rates will be paid to consultants who use their
own vehicles for official journeys, other than in the circumstances described in
paragraphs 15, 24 and 35 of these provisions, provided that a consultant may opt
to be paid mileage allowances at standard rates, notwithstanding his or her
entitlement to payment at regular user rates.
Public transport mileage rate

24. The foregoing rates shall not apply if a consultant uses a private motor vehicle in
circumstances where travel by a public service (e.g. rail, bus) would be
appropriate. For such journeys, an allowance at the public transport rate shall be
paid, unless this is higher than the rate that would be payable at the standard,
regular user or special rate. Further guidance on the application of the public
transport mileage rate is attached at Annex B.
Passenger allowances
25. Where other employees or members of an employing organisation are conveyed
in the same vehicle, other than a Lease Car, on the business of the National
Health Service and their fares by a public service would otherwise be payable by
the employing organisation, passenger mileage allowance shall be paid.
Garage expenses, tolls and ferries

26. Subject to the production of vouchers wherever possible, consultants using their
private motor vehicles on an official journey at the standard, regular user or
special rate of mileage allowance shall be refunded reasonable garage and
parking expenses and charges for tolls and ferries necessarily incurred, except
that charges for overnight garaging or parking shall not be reimbursed, unless the
consultant is entitled to night subsistence allowance for overnight absence.
Similar expenses may also be refunded to consultants only entitled to the public
transport rate of mileage allowance, provided that the total reimbursement for an
official journey does not exceed the cost which would otherwise have been
incurred on public transport, including the fares of any official passengers.
Loans for car purchase

27. The provisions of this paragraph apply to consultants who qualify for the first time
as essential car users in the NHS, other than those who are offered, or provided
with, a suitable Lease Car.
28. Such consultants are entitled to a loan at 2% flat rate of interest, provided that
the request for the loan is made within three months of such classification, or of
taking up the post (whichever is the later).
29. Loans shall be made in accordance with the provisions of paragraphs 22 to 27 of

Section 24 of the General Council Conditions of Service.
30. In determining whether a car is "suitable" for the purposes of these provisions,
various factors may need to be taken into account, such as the total official
mileage to be driven, reliability, the need to carry heavy or bulky equipment and
local road conditions, etc.
Pedal cycles
31. Consultants using pedal cycles for official journeys may be reimbursed at the rate
set out in Annex A, Table 1.
55
Lease cars
Allocation
32. For the purposes of paragraphs 33 to 54, a "Lease Car" is any vehicle owned or
contract-hired by an employing organisation.
33. Employing organisations may offer Lease Cars for individual use on official
business where they deem it economic (see also paragraph 51 of these
provisions) or otherwise in the interest of the service to do so.
34. Consultants who are required to travel on NHS business and have been classified
by the employing organisation as regular or essential users may continue to
receive the regular user lump sum payments and allowances set out in Annex A,
Table 1 for so long as they remain in the same post or until they voluntarily
accept the offer of a Lease Car.
New appointees
35. A consultant who was a new appointee after 1 April 2003 (including a consultant
who voluntarily moves post within the same employing organisation, or to a
different employing organisation) and who is required to travel on NHS business
and who chooses to use his or her own car, rather than to accept the employing
organisation's offer of a Lease Car, shall not receive the allowances specified in
paragraph 34 of these provisions, but shall be reimbursed at the special rate. The
special rate will be equivalent to the current 9,001 to 15,000 miles rate for over
2,000cc for regular and standard users, regardless of the vehicle's engine size.
36. A consultant who initially refused an offer of a Lease Car will continue to be
eligible for one, providing there has been no change in the consultant's duties.
37. A consultant who has been allocated a Lease Car for individual use on NHS
business is entitled to private use of the car, subject to the conditions set out in
paragraphs 41 to 54 of these provisions.
38. The offer of a Lease Car constitutes the offer of a base vehicle which should in
no case exceed 1800cc. Unless the consultant and the employing organisation
agree to the allocation of a smaller vehicle, it shall be at least 1500cc. In
determining the operational needs of a post for assessing the base vehicle
requirement, employing organisations shall have regard, in consultation with the
consultants concerned or their representatives, to:
(i) the clinical commitments of the postholder, including the nature,

frequency and urgency of the journeys to be undertaken;
(ii) the distances to be travelled;
(iii) the road, traffic and climatic conditions;
(iv) the physical requirements of the postholder; and
(v) the need to transport equipment.
39. A Lease Car which is no longer required by an individual member of staff may be
allocated to another for the remaining term of the contract (or notional contract).
56
In that event, the charges for private use will be based on the fixed annual
charges determined when the employing organisation first obtained the vehicle.
40. Employing organisations shall ensure that proper arrangements are made for the
economic servicing, repair, maintenance in a roadworthy condition and
replacement of Lease Cars.
Conditions of use
41. Following consultation with the representatives of the professions locally, an
employing organisation's conditions of use shall set out the consultant's
obligations in respect of the Lease Car and shall state the effect of the following
events on the contract and any subsequent financial liability on the consultant:
(i) breach of conditions of use;
(ii) disqualification from driving;
(iii) wilful neglect;
(iv) termination of the consultant's contract of employment, on: disciplinary

grounds; voluntary resignation; transfer to another employing
organisation (where practicable, reciprocal arrangements should be
made);
(v) change of duties resulting in the consultant no longer being required to

drive on official business;
(vi) substantial reduction in annual business mileage;
(vii) prolonged absence on annual, study, special or maternity leave.
Charges for private use

42. The basis of charges for private use set out in this paragraph assumes that
Lease Cars are provided on a contract-hire basis. Where this is not the case,
charges for private use are to be based on the notional cost to the employing
organisation of providing Lease Cars on a contract-hire basis. Notional contract-
hire charges at current rates are to be used, and the fixed charge to the
consultant for agreed private mileage determined on this basis is to remain
unaltered for the period for which the contract would have remained in force (e.g.
three years).
43. A consultant will be required to pay one composite annual charge for private use.
This will comprise the sum of the items listed in Annex A, Table 2. The composite
annual charge will be paid by monthly deduction from salary of one twelfth of the
total.
44. The basis of the fixed charge for agreed private mileage shall be the consultant's
estimate to the nearest thousand miles of his or her annual private mileage, as
agreed by the employing organisation and multiplied by the rate per thousand
miles, determined in accordance with the formula set out in Annex A, Table 2,
Paragraph B.
45. In the event that a consultant underestimates his or her annual private mileage,
an excess charge will be levied by the employing organisation, based on the
contract-hirer's excess charge to the employing organisation for the particular car
57
hired to the consultant. In the event that a consultant overestimates his or her
annual private mileage, any sum recoverable by the employing organisation from
the contract-hirer in respect of the overestimate will be refundable to the
consultant. If no recovery is available to the employing organisation, no refund
will be made to the consultant.
46. A consultant shall meet the cost to the employing organisation of the fitting of any
optional extras the consultant requires, and the contract between the employing
organisation and the consultant should specify whether such extras will become
the property of the contract-hirer or the consultant. In the latter case, the
consultant shall be liable for the cost of making good any damage caused to the
car by the removal of such fittings at the end or on early termination of the
contract. However, if such alterations are required because the consultant has a
certified disability, then the costs shall be met by the employing organisation.
47. In the event of a consultant's death in service or an early termination of the

consultant's contract on the grounds of ill health, there shall be no financial
penalty to the consultant or the consultant's estate on account of the early
termination of the contract for private use of the Lease Car.
48. In the event of a consultant's absence from work for an extended period on
maternity, sick, study or special leave, a consultant who has contracted for
private use of a Lease Car may choose to continue the private use at the
contracted charge or to return the vehicle to the employing organisation. In the
latter case, there shall be no financial penalty to the consultant on account of
early termination of the contract.
Alternative vehicle
49. Subject to the agreement of the employing organisation, which shall not be
unreasonably withheld, a consultant who wishes to contract for private use of a
Lease Car may choose a larger or more expensively equipped vehicle than that
offered. In this event, the consultant shall be responsible for meeting the
additional costs to the employing organisation by means of an addition to the
composite annual charge, which shall be paid by monthly deduction from salary
of one twelfth of the total determined. The rate for reimbursement of petrol used
on official business shall be that of the appropriate base vehicle.
Reimbursement of petrol and other costs

50. A consultant who has been allocated a Lease Car will be responsible for
purchasing all petrol, whether for business or private mileage.
51. NHS business mileage costs will be reimbursed by reference to a claim form or
diary showing daily visits on NHS business signed by the consultant. NHS
business mileage costs include journeys for which a mileage allowance would be
payable under paragraphs 7 to 13 of these provisions.
52. The rate per mile will be determined according to the following formula:
Cost of one gallon of premium unleaded petrol*

Base Vehicle's mileage on urban cycle
*The price of petrol will be as recommended from time to time by the Department
of Health or any new employers body to whom this function may in future be
delegated. The mileage on the urban cycle will be as quoted by manufacturers
58
from officially approved tests under the Passenger Car Fuel Consumption Order
1983.
53. The provisions of paragraph 26 of these provisions shall apply to expenses

incurred by a consultant using a Lease Car on official business.
Carriage of passengers
54. Liability for compensation of authorised official passengers injured while being
carried in a Lease Car will be borne by the employing organisation. It is for each
employing organisation to reach a view and issue advice to consultants on the
carriage of official passengers.
Other expenses
Subsistence allowances
55. The provisions of Section 22 of the General Council Conditions of Service shall
apply, with the following provisos:
56. For the purposes of this guidance the term "principal place of work" shall be
understood to mean "the NHS facility where the consultant's principal duties lie",
except in the case of consultants who work occasional sessions with the Blood
Transfusion Services in which case the regional headquarters of the Blood
Transfusion Service shall be considered to be the principal place of work for any
such sessions.
57. No day allowance shall be payable in respect of any period spent at a NHS
facility as part of the Programmed Activities of the consultant concerned.
Postage etc
58. Any expenditure necessarily incurred by a consultant on postage or telephone
calls in the service of an employing organisation shall be reimbursed, through the
periodical claim for travelling and subsistence.
Expenses of candidates for appointments

59. The provisions of this paragraph shall apply where an employing organisation
summons a consultant to appear before a selection board or invites a short-listed
consultant to attend in connection with his or her application for appointment.
(i) reimbursement of eligible expenses shall be made by the prospective

(ii) where a consultant holds a paid or honorary appointment with an

employing organisation and applies for a new post with his or her own
or another employing organisation, the consultant is entitled to
travelling expenses in accordance with paragraph 3 of these
provisions and to subsistence allowance in accordance with
paragraphs 55 to 57.
(iii) where a consultant to whom sub-paragraph (ii) does not apply

provides general medical or dental services under Part II of the
National Health Service (Scotland) Act 1978, or is an assistant to such
a consultant, he or she is entitled to travelling expenses and
subsistence allowance at the higher rate applicable under paragraphs
55 to 57 of these provisions.
59
(iv) a consultant to whom sub-paragraphs (ii) and (iii) do not apply may at
the discretion of the employing organisation be reimbursed travelling
expenses and subsistence allowance, subject, unless the
circumstances warrant exceptional treatment, to the maximum that
would have been payable had those provisions applied.
(v) a candidate for a consultant appointment shall not be reimbursed for

more than three attendances. Where an employing organisation
invites such a candidate to attend prior to short-listing, it may
reimburse the candidate's expenses provided that he or she is
subsequently short-listed, but not otherwise.
(vi) a candidate to whom sub-paragraph (v) does not apply shall not be
reimbursed for more than two attendances.
60. A consultant to whom sub-paragraph 59(ii) applies and who is summoned to

appear before a selection board while on holiday shall be reimbursed for:
(i) travelling expenses from the consultant's holiday address, but limited
in the case of travel from abroad to expenses from the port of entry in
Great Britain, provided that the consultant returns to his or her holiday
address after interview; for this purpose, travel from Northern Ireland,
the Isle of Man and the Channel Islands shall not be regarded as
travel from abroad; and
(ii) subsistence allowance at the appropriate rate, unless the consultant is

able to stay at his or her own home and it is reasonable to expect the
consultant to do so.
61. Reimbursement shall not be made to a consultant who refuses the offer of the
appointment as advertised on grounds which the employing organisation
considers inadequate.
Removal expenses
62. The provisions of Section 26 of the General Council Conditions of Service shall
apply.
60
Annex A Allowances and charges for private use
Table 1: Mileage allowances
NB These rates will be updated from time to time by the employing

organisation
1 Public transport rate: 24p per mile.
2 Regular user rates:
Motor cars:
Engine capacity (cc) 501 to 1000 1,001 to 1,500 1,501 to 2,000 over 2,000
Lump sum () 508 626 760 760
Up to 9,000 miles (p) 29.7 36.9 44.0 44.0
9,001 - 15,000 miles (p) 17.8 20.1 22.6 22.6
Thereafter (p) 17.8 20.1 22.6 22.6
3 Standard rates:
Motor cars:
Motor cars:
Engine capacity (cc) 501 to 1000 1,001 to 1,500 1,501 to 2,000 over 2,000
Up to 3,500 miles (p) 37.4 447.3 58.3 58.3
3,501 - 9,000 miles (p) 23.0 28.2 33.5 41.0
9,001 - 15,000 miles (p) 17.8 20.1 22.7 25.5
Thereafter (p) 17.8 20.1 22.6 22.6
4 Other motor vehicles:
Engine capacity (cc) Up to 125 Over 125

Up to 5,000 miles (p) 17.8 27.8
Over 5,000 miles (p) 6.7 9.9
5 Passenger allowance:
Each passenger: 5 p per mile
6 Pedal cycles: 10p per mile
61
Table 2: Lease cars charges for private use of allocated lease cars
NB These rates will be updated from time to time by the employing

organisation
A. The current rates of:
Road Fund Licence e.g. 155
Insurance for Private Use *

(National call-off contract) e.g. 88
Including cover for private use: e.g. 128
Handling charge 95
B. Fixed Annual Charge per 1,000 private miles (for each year of the
contract or notional contract), determined as follows:
Cost of Contract Hire at Cost of Contract Hire at

maximum quoted mileage minimum quoted mileage
1000
Plus total excess costs for non-base vehicle, where appropriate.
Plus VAT on total charge to consultant (A+B).
NB: Where the cost to the employing organisation of hiring the car includes
Road Fund Licence and/or Insurance, these items should be extracted
and the net cost used in calculating the charge per 1,000 miles.
Lease Cars, while used solely on NHS business, do not require to

be taxed or insured for the purposes of the Road Traffic Act 1972;
any private mileage requires that the vehicle be taxed and insured.
62
Annex B Application of the public transport user rate
1. This annex provides further guidance on the application of the public transport
user rate instead of the standard mileage rate, under the provisions set out in
paragraph 23 of the main body of this guidance.
2. If mileage allowance is payable, the public transport rate (set out in Annex A,
Table 1) should be paid where travel by a public service is appropriate, but the
consultant prefers to use a private means of transport instead. In all other
circumstances, the standard or regular user rates apply.
3. Employers should use the following criteria in deciding whether the public
transport rate should apply:
the nature of the consultants duties;
the length and complexity of journeys (including the number of changes
and likely waiting times;
the availability of public transport;
personal safety;
the time of day
relative journey times (public transport compared with private vehicle)
any other relevant factors, for example, equipment or luggage to be
carried.
4. In particular, employers should take into account the variable times at which
consultants start and finish work when public transport may not be a viable way
of travelling.
63
Schedule 22 Locum consultants
1. The provisions of these terms and conditions shall apply to locum consultants,
subject to the provisions set out below.
2. Locum consultants should ordinarily be included on the General Medical

Councils, or the General Dental Councils, Specialist Register. Where,
exceptionally, doctors or dentists not included on either Specialist Register are
appointed to locum consultant posts, terms and conditions shall subject to the
provisions below be on the same basis as for other locum appointments.
Appointment and tenure of post

3. Locum appointments should be made in line with guidance issued by the
Department of Health. Locum appointments are not permanent posts; tenure will
be as agreed on appointment.
Basic salary
4. Locum consultants who have not at any time held a substantive consultant post
shall be remunerated at the equivalent rate to the first point on the salary scale,
subject to the provisions for pay progression set out below and subject to
recognising any approved non-NHS consultant level experience. Where a locum
consultants training has been lengthened by virtue of being in a flexible training
scheme or because of undergoing dual qualification (required for the locum post
concerned), the employing organisation will, where necessary, credit appropriate
additional seniority to ensure that the locum consultant is not prevented from
reaching the pay threshold they would have attained had they trained on a full
time or single qualification basis (e.g. training extended by two years counts as
the equivalent of two years consultant level experience where a locum
consultants would not otherwise be able to reach the same pay threshold).20
5. Locum consultants who hold a substantive consultant post (either within the
employing organisation, or with another NHS employer) and will continue to hold
such a post beyond the tenure of the locum post shall be remunerated at a rate
consistent with their current pay threshold, or rate of pay, including any
Distinction Award, Discretionary Points or Clinical Excellence Awards.21
6. Locum consultants who do not currently hold a substantive consultant post with
the relevant employer (e.g. retired consultants) shall be remunerated at a rate
consistent with their most recent pay threshold as a substantive consultant or, for
those who have not previously held employment under these Terms and
Conditions, their calculated seniority, subject to the provisions for pay
progression set out below.22
Pay progression
7. A locum in post for a period of six months will become subject to the Job
Planning process. Where a locum doctor is covered by the Job Planning process
and has completed twelve months locum service, whether continuous or
cumulative, there shall be an assessment of whether he or she has met the
criteria set out in Schedule 15 for pay progression in respect of that years
service. Subject to meeting the criteria in respect of the relevant year(s), locums
shall receive pay progression in the same way as substantive consultants.23
8. Where a locum consultant is approaching the completion of twelve months

service, the current employing organisation is responsible for making a decision
64
as to whether the criteria for pay progression have been met in respect of that
year. Where part of the previous twelve months service has been for one or
more other NHS employing organisations, the current employing organisation
shall ensure that they receive an assurance as to whether the criteria have been
met in respect of this other service.
9. Where Associate Specialists have been paid in their previous regular

employment at a basic salary, including any discretionary points, higher or equal
to the rate at which they would (were it not for this provision) be paid on taking up
their new locum consultant appointment, then their starting salary in the new
appointment shall be fixed at the threshold in the scale next above that previous
rate.60
65
Schedule 23 Application of terms and conditions of service
for NHS consultant clinical academics1, 24, 37
1. The following schedule applies to a consultant clinical academic holding an

honorary (unpaid) NHS contract and a substantive contract of employment with
an academic institution (normally a University) which is responsible for
remunerating the whole of the academics duties. Such duties will be agreed in
an integrated Job Plan. In managing the contracts of clinical academics, NHS
employers shall be informed by the Guidance Notes for the Employment of
Consultant Clinical Academics (England) 2003 (amended August 2006).
2. This schedule does not form any part of a contract with a non-NHS
employer.
3. Table 1 sets out the Schedules of these Terms and Conditions that shall apply to
the honorary consultant post held by a clinical academic.
4. Reference to supporting guidance is given to facilitate implementation only

and is not part of the contract.
Table 1 Application of schedules to honorary consultant posts
Schedule 1 Commencement of Shall apply (see also paragraph 28 of accompanying

Employment guidance)
Schedule 2 Associated Duties and Shall apply, except that, where a clinical academic is
Responsibilities asked to deputise for an absent colleague (paragraph 3),
account shall be taken of the clinical academics duties
for the substantive employer.
Schedule 3 Job Planning Shall apply, except that:
the substantive employer shall be party to a joint Job
Planning process.
the recommendation on pay progression (paragraph
21) shall be a joint recommendation, agreed
between the substantive employer and the honorary
employer. And,
where the clinical academics duties or
responsibilities have changed during the year the
substantive employer will also be able to propose
amendment to the Job Plan.
There should be appropriate application of the Follett

principles in the agreement of clinical academic
integrated Job Plans, outlined in the accompanying
guidance.
Schedule 4 Mediation and Appeals Shall not apply. The provisions of Annex B of the
honorary consultant contract (England) replace
Schedule 4 for clinical academics.
Schedule 5 Recognition for Emergency Shall apply.
Work Arising from On-Call
Duties
Schedule 6 Extra Programmed Activities Shall apply.
and Spare Professional
Capacity The requirement for the individual to undertake one
additional Programmed Activity (if offered by either
employer) before undertaking private practice should
apply to clinical academics where they personally profit
from undertaking privately remunerated clinical work.
66
Where the proceeds are retained by, or used to the
benefit of, the University there should be no expectation
that he or she should undertake an additional
Programmed Activity in order to qualify for pay
progression.
The utilisation of additional Programmed Activities

should be subject to agreement between the clinical
academic consultant, the University employer and the
honorary NHS employer.
Schedule 7 Premium Time Shall apply.
Schedule 8 On-Call Rotas Shall apply.
Schedule 9 Provisions Governing The Shall apply, except that the substantive employers rules
Relationship Between NHS about undertaking private practice may also apply.
Work, Private Practice and Fee
Paying Services
Schedule 10 Fee Paying Services Shall apply. Any separate Fee Paying Services
undertaken explicitly on behalf of the academic
employer will be exempt from NHS rules.
Schedule 11 Principles Governing Receipt of Shall apply. Any separate Fee Paying Services
Additional Fees undertaken explicitly on behalf of the academic
employer will be exempt from NHS rules.
Schedule 12 Other Conditions of Shall apply, except that paragraph 2 will not normally
Employment apply.
Schedules Salary and Pay Thresholds Clinical academic pay is covered by the substantive
13 15 contract
Schedule 16 Pay Supplements Shall apply, except that:
all payable supplements, including (where
appropriate) London weighting and Recruitment or
Retention Premia, will be paid by the substantive
employer. Any Recruitment and Retention Premia
will be jointly agreed on appointment or as part of
the integrated Job Planning process.
Paragraphs 9 to 15 shall not apply.
Schedule 17 Pension Arrangements Clinical academics who are continuing contributors to
the NHSPS shall have the option to contribute to the
USS or to remain in the NHSPS, subject to the terms of
that scheme.
Schedule 18 Leave and Public Holidays Does not apply, except that:
Leave entitlement for clinical academics will be
determined by the University employer, but should
be no less favourable than that available in the NHS;
and
The timing of leave will need to be agreed in
advance with both employers.
Schedule 19 Termination of Employment Shall apply.
Schedule 20 Incorporated General Council The contract does not change any existing applicability
Conditions of Service of General Whitley Council provisions.
Schedule 21 Model Provisions for Expenses Shall apply, except that:
NHS Consultants only costs incurred during the course of carrying out
duties under the honorary contract may be claimed.
Schedule 22 Locum Consultants Shall apply
Schedule 24 Maternity Leave and Pay Shall not apply.

(Temporary schedule)
67
Schedule 25 Employment Break Scheme Shall not apply
(Temporary Schedule)
Schedule 26 Redundancy Pay (Temporary Shall not apply

Schedule)
Schedule 27 Caring for Children and Adults Shall not apply

Schedule 28 Flexible working arrangements Shall not apply

Schedule 29 Balancing Work and Personal Shall not apply

Life (Temporary Schedule)
68
Schedule 24 Maternity leave and pay (temporary schedule)25,
38
Introduction
1. All employees will have the right to take 52 weeks of maternity leave
2. Paragraphs 7 to 54 of this Schedule set out the maternity leave and

pay entitlements of NHS employees under the NHS contractual
maternity leave scheme.
3. Paragraphs 55 to 59 give information about the position of staff who

are not covered by this scheme because they do not have the
necessary service or do not intend to return to NHS employment.
4. Paragraphs 60 to 64 define the service that can be counted towards

the twelve month continuous service qualification set out in paragraph
7 (i) below and which breaks in service may be disregarded for this
purpose.
5. Paragraph 65 explains how to get further information about employees

statutory entitlements.
6. Where locally staff and employer representatives agree arrangements

which provide benefits to staff, beyond those provided by this section,
those local arrangements will apply.
Eligibility
7. An employee working full-time or part-time will be entitled to paid and

unpaid maternity leave under the NHS contractual maternity pay
scheme if:
- (i) she has twelve months continuous service (see

paragraphs 60 to 64) with one or more NHS
employers at the beginning of the eleventh week before
the expected week of childbirth;
- (ii) she notifies her employer in writing before the end of the
15th week before the expected date of childbirth (or if this
is not possible, as soon as is reasonably practicable
thereafter):
(a) of her intention to take maternity leave;
(b) of the date she wishes to start her maternity leave

she can choose when to start her maternity
leave this can usually be any date from the
69
beginning of the 11th week before the baby is born
(but see paragraph 8 below);
(c) that she intends to return to work with the same or

another NHS employer for a minimum period of
three months after her maternity leave has ended;
(d) and provides a MATB1 form from her midwife or

GP giving the expected date of childbirth.
Changing the Maternity Leave Start Date
8. If the employee subsequently wants to change the date from which she
wishes her leave to start she should notify her employer at least 28
days beforehand (or, if this is not possible, as soon as is reasonably
practicable beforehand).
Confirming Maternity Leave and Pay
9. Following discussion with the employee, the employer should confirm

in writing:
- (i) the employees paid and unpaid leave entitlements under

this agreement (or statutory entitlements if the
employee does not qualify under this agreement);
- (ii) unless an earlier return date has been given by the

employee, her expected return date based on her 52
weeks paid and unpaid leave entitlement under this
agreement; and
- (iii) the length of any period of accrued annual leave which it

has been agreed may be taken following the end of the
formal maternity leave period (see paragraphs
49 and 50 below);
- (iv) the need for the employee to give at least 28 days notice
if she wishes to return to work before the expected return
date.
Keeping in Touch
10. Before going on leave, the employer and the employee should also
discuss and agree any voluntary arrangements for keeping in touch
during the employees maternity leave including:
- (i) any voluntary arrangements that the employee may find

helpful to help her keep in touch with developments at
work and, nearer the time of her return, to help
facilitate her return to work;
70
- (ii) keeping the employer in touch with any
developments that may affect her intended date of return.
Work During the Maternity Leave Period
Keeping in Touch Days
11. To facilitate the process of Keeping in Touch Days (KIT days) it is

important that the employer and employee have early discussion to
plan and make arrangements for KIT days before the employees
maternity leave takes place.
12. To enable employees to take up the opportunity to work KIT days

employers should consider the scope for reimbursement of reasonable
childcare costs or the provision of childcare facilities.
13. KIT days are intended to facilitate a smooth return to work for women
returning from maternity leave.
14. An employee may work for up to a maximum of 10 KIT days without

bringing her maternity leave to an end. Any days of work will not
extend the maternity leave period.
15. An employee may not work during the two weeks of compulsory
maternity leave immediately after the birth of her baby
16. The work can be consecutive or not and can included training or other
activities which enable the employee to keep in touch with the
workplace.
17. Any such work must be by agreement and neither the employer nor the
employee can insist upon it.
18. The employee will be paid at their basic daily rate, for the hours worked
less appropriate maternity leave payment for KIT days worked.
19. Working for part of any day will count as one KIT day
20. Any employee who is breastfeeding must be risk assessed and

facilities provided in accordance with paragraph 34
Paid Maternity Leave
Amount of Pay
21. Where an employee intends to return to work the amount of contractual

maternity pay receivable is as follows:
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- (i) for the first eight weeks of absence, the employee will
receive full pay, less any Statutory Maternity Pay or
Maternity Allowance (including any dependants
allowances) receivable;
- (ii) for the next 18 weeks, the employee will receive half of
full pay plus any Statutory Maternity Pay or Maternity
Allowance (including any dependants allowances)
receivable, providing the total receivable does not exceed
full pay.
- (iii) for the next 13 weeks, the employee will receive any
Statutory Maternity Pay or Maternity Allowance that they
are entitled to under the statutory scheme
22. By prior agreement with the employer occupational maternity pay may
be paid in a different way, for example a combination of full pay and
half pay or a fixed amount spread equally over the maternity leave
period.
Calculation of Maternity Pay
23. Full pay will be calculated using the average weekly earnings rules
used for calculating Statutory Maternity Pay entitlements, subject to the
following qualifications:
- (i) in the event of a pay award or annual increment being

implemented before the paid maternity leave period
begins, the maternity pay should be calculated as though
the pay award or annual increment had effect throughout
the entire Statutory Maternity Pay calculation period. If
such a pay award was agreed retrospectively, the
maternity pay should be re-calculated on the same basis;
- (ii) in the event of a pay award or annual increment being

implemented during the paid maternity leave period, the
maternity pay due from the date of the pay award or
annual increment should be increased accordingly. If
such a pay award was agreed retrospectively, the
maternity pay should be re-calculated on the same
basis;
- (iii) in the case of an employee on unpaid sick absence or on

sick absence attracting half pay during the whole or part
of the period used for calculating average weekly
earnings in accordance with the earnings rules for
Statutory Maternity Pay purposes, average weekly
earnings for the period of sick absence shall be
calculated on the basis of notional full sick pay.
72
Unpaid Contractual Leave
24. Employees are also entitled to take a further 13 weeks as unpaid

leave to bring the total of leave to 52 weeks. However, this may be
extended by local agreement in exceptional circumstances for
example, where employees have sick pre-term babies or multiple
births.
Commencement and Duration of Leave
25. An employee may begin her maternity leave at any time between
eleven weeks before the expected week of childbirth and the
expected week of childbirth provided she gives the required notice.
Sickness Prior to Childbirth
26. If an employee is off work ill, or becomes ill, with a pregnancy

related illness during the last four weeks before the expected week
of childbirth, maternity leave will normally commence at the
beginning of the fourth week before the expected week of childbirth
or the beginning of the next week after the employee last worked,
whichever is the later. Absence prior to the last four weeks before
the expected week of childbirth, supported by a medical statement
of incapacity for work, or a self-certificate, shall be treated as sick
leave in accordance with normal leave provisions.
27. Odd days of pregnancy related illness during this period may be
disregarded if the employee wishes to continue working till the
maternity leave start date previously notified to the employer.
Pre-term Birth
28. Where an employees baby is born alive prematurely the employee

will be entitled to the same amount of maternity leave and pay as if
her baby was born at full term.
29. Where an employees baby is born before the eleventh week before
the expected week of childbirth and the employee has worked
during the actual week of childbirth, maternity leave will start on the
first day of the employees absence.
the expected week of childbirth and the employee has been absent
from work on certified sickness absence during the actual week of
childbirth, maternity leave will start the day after the day of birth.
the expected week of childbirth and the baby is in hospital the
employee may spilt her maternity leave entitlement, taking a
minimum period of two weeks leave immediately after childbirth
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and the rest of her leave following her babys discharge from
hospital.
Still Birth
32. Where an employees baby is born dead after the 24th week of
pregnancy the employee will be entitled to the same amount of
maternity leave and pay as if her baby was born alive.
Miscarriage
33. Where an employee has a miscarriage before the 25th week of

pregnancy normal sick leave provisions will apply as necessary.
Health and Safety of Employees Pre and Post Birth
34. Where an employee is pregnant, has recently given birth or is

breastfeeding, the employer must carry out a risk assessment of
her working conditions. If it is found, or a medical practitioner
considers, that an employee or her child would be at risk were she
to continue with her normal duties the employer should provide
suitable alternative work for which the employee will receive her
normal rate of pay. Where it is not reasonably practicable to offer
suitable alternative work the employee should be suspended on full
pay.
35. These provisions also apply to an employee who is breastfeeding if

it is found that her normal duties would prevent her from
successfully breastfeeding her child.
Return to Work
36. An employee who intends to return to work at the end of her full
maternity leave will not be required to give any further notification to
the employer, although if she wishes to return early she must give
at least 28 days notice.
37. An employee has the right to return to her job under her original
contract and on no less favourable terms and conditions.
Returning on Flexible Working Arrangements
38. If at the end of maternity leave the employee wishes to return to

work on different hours the NHS employer has a duty to facilitate
this wherever possible, with the employee returning to work on
different hours in the same job. If this is not possible the employer
must provide written, objectively justifiable reasons for this and the
employee should return to the same grade and work of a similar
nature and status to that which they held prior to their maternity
absence.
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39. If it is agreed that the employee will return to work on a flexible
basis, including changed or reduced hours, for an agreed temporary
period this will not affect the employees right to return to her job
under her original contract at the end of the agreed period.
Sickness Following the End of Maternity Leave
40. In the event of illness following the date the employee was due to
return to work normal sick leave provisions will apply as necessary.
Failure to Return to Work
41. If an employee who has notified her employer of her intention to

return to work for the same or a different NHS employer in
accordance with paragraph 7 (ii) (c) above fails to do so within 15
months of the beginning of her maternity leave she will be liable to
refund the whole of her maternity pay, less any Statutory Maternity
Pay, received. In cases where the employer considers that to
enforce this provision would cause undue hardship or distress the
employer will have the discretion to waive their rights to recovery.
Miscellaneous Provisions
Fixed Term Contracts or Training Contracts
42. Employees subject to fixed-term or training contracts which expire

after the eleventh week before the expected week of childbirth and
who satisfy the conditions in paragraphs 7 (i), 7 (ii) (a), 7 (ii) (b) and
7 (ii) (d) shall have their contracts extended so as to allow them to
receive the 52 weeks which includes paid contractual and statutory
maternity pay and the remaining 13 weeks of unpaid maternity
leave.
43. Absence on maternity leave (paid and unpaid) up to 52 weeks

before a further NHS appointment shall not constitute a break in
service.
44. If there is no right of return to be exercised because the contract

would have ended if pregnancy and childbirth had not occurred the
repayment provisions set out in paragraph 41 above will not apply.
45. Employees on fixed-term contracts who do not meet the twelve

months continuous service condition set out in paragraph 7 (i)
above may still be entitled to Statutory Maternity Pay.
Rotational Training Contracts
46. Where an employee is on a planned rotation of appointments with

one or more NHS employers as part of an agreed programme of
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training, she shall have the right to return to work in the same post
or in the next planned post irrespective of whether the contract
would otherwise have ended if pregnancy and childbirth had not
occurred. In such circumstances the employees contract will be
extended to enable the practitioner to complete the agreed
programme of training.
Contractual rights
47. During maternity leave (both paid and unpaid) an employee retains
all of her contractual rights except remuneration.
Increments
48. Maternity leave, whether paid or unpaid, shall count as service for
annual increments and for the purposes of any service qualification
period for additional annual leave.
Accrual of Annual Leave
49. Annual leave will continue to accrue during maternity leave,

whether paid or unpaid, provided for by this agreement.
50. Where the amount of accrued annual leave would exceed normal
carry over provisions, it may be mutually beneficial to both the
employer and employee for the employee to take annual leave
before and/or after the formal (paid and unpaid) maternity leave
period. The amount of annual leave to be taken in this way, or
carried over, should be discussed and agreed between the
employee and employer. Payment in lieu may be considered as an
option where accrual of annual leave exceeds normal carry over
provisions.
Pensions
51. Pension rights and contributions shall be dealt with in accordance

with the provisions of the NHS Superannuation Regulations.
Antenatal Care
52. Pregnant employees have the right to paid time off for antenatal
care. Antenatal care includes relaxation and parent-craft classes as
well as appointments for antenatal care.
Post-natal Care and Breastfeeding Mothers
53. Women who have recently given birth should have paid time off for
post-natal care e.g. attendance at health clinics.
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54. Employers are required to undertake a risk assessment and to
provide breastfeeding women with suitable private rest facilities.
The Health and Safety Executive Guidance recommends that
employers provide:
o a clean, healthy and safe environment for women who are

breastfeeding,
o suitable access to a private room to express and store milk in an
appropriate refrigerator.
Employers are reminded that they should consider requests for

flexible working arrangements to support breastfeeding women at
work
Employees Not Returning to NHS Employment
55. An employee who satisfies the conditions in paragraph 7, except

that she does not intend to work with the same or another NHS
employer for a minimum period of three months after her maternity
leave is ended, will be entitled to pay equivalent to Statutory
Maternity Pay, which is paid at 90% of her average weekly earnings
for the first six weeks of her maternity leave and to a flat rate sum
for the following 33 weeks.
Employees With Less Than Twelve Months Continuous Service
56. If an employee does not satisfy the conditions in paragraph 7 for

occupational maternity pay she may be entitled to Statutory
Maternity Pay. Statutory Maternity Pay will be paid regardless of
whether she satisfies the conditions in paragraph 7.
57. If her earnings are too low for her to qualify for Statutory Maternity
Pay, or she does not qualify for another reason, she should be
advised to claim Maternity Allowance from her local Job Centre
Plus or social security office.
58. All employees will have a right to take 52 weeks of maternity leave
whether they return to NHS Employment or not.
59. Paragraph 65 contains further information on statutory maternity

entitlements.
Continuous Service
60. For the purposes of calculating whether the employee meets the
twelve months continuous service with one or more NHS employers
qualification set out in paragraph 7 (i) the following provisions shall
apply:
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- (i) NHS employers includes health authorities, NHS Boards,
NHS Trusts, Primary Care Trusts and the Northern
Ireland Health Service;
- (ii) a break in service of three months or less will be

disregarded (though not count as service).
61. The following breaks in service will also be disregarded (though not
count as service);
- (i) employment under the terms of an honorary contract;
- (ii) employment as a locum with a general practitioner for a

period not exceeding twelve months;
- (iii) a period of up to twelve months spent abroad as part of a

definite programme of postgraduate training on the
advice of the Postgraduate Dean or College or Faculty
Advisor in the speciality concerned;
- (iv) a period of voluntary service overseas with a recognised

international relief organisation for a period of twelve
months which may exceptionally be extended for twelve
months at the discretion of the employer which recruits
the employee on her return;
- (v) absence on a employment break scheme in accordance

with the provisions of Schedule 25 ;
- (vi) absence on maternity leave (paid or unpaid) as provided

for under this agreement.
62. Employers may at their discretion extend the period specified in

paragraphs 60 (ii) and 61.
63. Employment as a trainee with a General Medical Practitioner in

accordance with the provisions of the Trainee Practitioner Scheme
shall similarly be disregarded and count as service.
64. Employers have the discretion to count other previous NHS service
or service with other employers.
Information about Statutory Maternity/Adoption and Paternity

Maternity Leave and Pay
65. There are occasions when employees are entitled to other statutory
benefits/allowances and Information about all statutory
maternity/adoption and paternity rights can be found using the
following links:
78
http://www.dti.gov.uk/employment/workandfamilies/maternity-
leave-pay/guidance/page21116.html
http://www.dwp.gov.uk/lifeevent/benefits/statutory_maternity_
pay.asp
http://jobcentreplus.gov.uk/JCP/Customers/WorkingAgeBenefi
ts/Dev_008115.xml.html
Information about Health and Safety for new and expectant

mothers at work can be found using the following link:-
www.hse.gov.uk
79
Schedule 25 Employment break scheme (temporary
schedule)
General
1. NHS employers should provide all staff with access to an employment break
scheme.
2. The scheme should be agreed between employers and local staff

representatives.
3. The scheme should be viewed with others, particularly those relating to

flexible working, balancing work and personal life, and provisions for carers,
as part of the commitment to arrangements which enable employees to
balance paid work with their other commitments and responsibilities.
4. The scheme should also enable employers to attract and retain the
experience of staff consistent with the NHS commitment to the provision of
high quality healthcare.
5. The scheme should provide for people to take a longer period away from
work than that provided for by the parental leave and other leave
arrangements.
Scope
6. The scheme should explicitly cover the main reasons for which employment
breaks can be used, including childcare, eldercare, care for another
dependant, training, study leave or work abroad. It should also indicate that
other reasons will be considered on their merits.
7. People on employment breaks will not normally be allowed to take up paid

employment with another employer except where, for example, work
overseas or charitable work could broaden experience. In such
circumstances written authority from the employer would be necessary.
Eligibility
8. The employment break scheme should normally be open to all employees

who have a minimum of twelve months service.
9. Applications should be submitted in writing and notice periods should be

clearly stated in an agreement between the employee and employer.
Length of break
10. The maximum length of break should be five years.
11. Breaks should be able to be taken either as a single period or as more than
one period.
12. The minimum length of break should be three months.
80
13. The length of any break should balance the needs of the applicant with the
needs of the service.
14. The scheme should have provision for breaks to be extended with appropriate
notice, or for early return from breaks.
15. All breaks should be subject to an agreement between the employer and
applicant before the break begins. The agreement should cover:
- the effect of the break on various entitlements related to length of

service;
- a guarantee that, if the applicant returns to work within one year, the
same job will be available, as far as is reasonably practicable;
- if the break is longer than one year, the applicant may return to as
similar a job as possible;
- return to work at the equivalent salary level, reflecting increases

awarded during the break;
- the notice period required before the return to work should be two
months if the break is less than a year and six months if the break is
more than a year;
- arrangements for keeping in touch during the break;
- requirements on the applicant to keep up to date with their relevant

professional registration needs, including attendance at specified
training courses and conferences, and any assistance the employer
may give in the support of this;
- training arrangements for re-induction to work;
- any other conditions required either by the employer or the applicant.
Return to work
16. Applicants should not have to resign to take an employment break, although
there will be a change to the contract of employment.
17. The period of the break should count toward continuous employment for
statutory purposes.
18. Other provisions depending upon length of service, i.e. pensions, contractual
redundancy payments, leave entitlements etc, should be suspended for the
period of the break.
Appeals
19. Applicants should be entitled to a written reason for the refusal of any
application.
20. Applicants may resort to the grievance procedure if a request for a break is
refused.
81
Monitoring and review
21. All records of applications and decisions should be kept for a minimum of
twelve months.
22. The operation of the scheme should be monitored annually by employers in

partnership with local staff representatives. This will include consideration of
diversity data.61
82
Schedule 26 Redundancy pay (temporary schedule)31
1. This section sets out the arrangements for redundancy pay for employees
dismissed by reason of redundancy who, at the date of termination of their
contract, have at least 104 weeks of continuous full-time or part-time service.
These take effect from 1 October 2006. It also sets out the arrangements for
early retirement on grounds of redundancy and in the interests of the service for
those who are members of the NHS pension scheme and have at least two
years continuous full time or part time service and two years qualifying
membership in the NHS pension scheme. Pension changes take effect from 1
December 2006. 62
Definition of redundancy
2. The Employment Rights Act 1996 Section 139 states that redundancy arises
when employees are dismissed in the following circumstances:
"where the employer has ceased, or intends to cease, to carry on the

business for the purposes of which the employee was employed; or where the
employer has ceased, or intends to cease, to carry on the business in the
place where the employee was so employed; or
where the requirements of the business for employees to carry out work of a
particular kind, in the place where they were so employed, have ceased or
diminished or are expected to cease or diminish.
Qualification for a redundancy payment
3. To qualify for a redundancy payment, the member of staff must be an

employee, working under a contract of employment for an NHS employer. NHS
employer means NHS trusts, primary care trusts, strategic health authorities
and special health authorities and any predecessor or successor body. Non
executive directors of NHS organisations do not qualify. Contracts of
employment may be written or verbal, and can be for a fixed period or be
continuous. In law, employees have a contract as soon as they start work and
in accepting and undertaking the work required they accept the terms and
conditions offered by the employer. To qualify for a redundancy payment the
employee must also have at least 104 weeks of continuous full time or part time
service.
Definition of continuous service
4. Continuous service means full-time or part-time employment with the present

or any previous NHS Employer. If with more than one NHS employer, there
must not have been a break of more than a week (measured Sunday to
Saturday) between employments.
Definition of reckonable service
5. Reckonable service for the purposes of an NHS redundancy payment, which

is calculated on the basis of the service up to the date of termination of the
contract, means continuous full-time or part-time employment with the present
or any previous NHS employer but with the following additions:
83
where there has been a break in service of 12 months or less the period of
employment prior to the break will count as reckonable service;
periods of employment as a trainee with a general medical practitioner in
accordance with the provisions of the Trainee Practitioner Scheme will
count as reckonable service;
at employer discretion, any period or periods of employment with employers
outside the NHS where these are judged to be relevant to NHS employment
can be included in reckonable service.
6. The following employment will not count as reckonable service:
employment that has been taken into account for the purposes of a
previous redundancy, or loss of office payment by an NHS employer;
where the employee has previously been given pension benefits, any
employment that has been taken into account for the purposes of those
pension benefits.
Definition of a months pay
7. Months pay means whichever is the more beneficial of the following

calculations:
4.35 times a weeks pay calculated in accordance with the provisions of

Section 221 to 229 of the Employment Rights Act 1996;
an amount equal to 1/12th of the annual salary in payment at the date of
termination of employment.
Calculation of redundancy payment
8. The redundancy payment will take the form of a lump sum, dependent on the
employees reckonable service at the date of termination of employment. The
lump sum will be calculated on the basis of one months pay for each complete
year of reckonable service subject to a minimum of two years (104 weeks)
continuous service and a maximum of 24 years reckonable service being
counted.
9. Fractions of a year of reckonable service will not be taken into account.
Early retirement on grounds of redundancy for employees entitled to

pension benefits
Qualification criteria
10. Members of the NHS Pension Scheme who are made redundant and meet the
conditions set out above in paragraphs 3 to 6, may choose to retire early
without reduction in the value of pension benefits as an alternative to receiving
the full lump sum benefit set out in paragraph 8. To qualify for early retirement
the member of staff must:
Be a member of the NHS Pension Scheme;

Have at least two years continuous service and two years qualifying
membership;
Have reached the minimum pension age. The Finance Act 2004 allows for
protection of a minimum pension age of 50 for members who had the right
84
to take reduced benefits at that age on 5 April 2006. This protection may
continue as long as members retiring early after 6 April 2010 take all their
benefits payable under scheme rules. In the NHS Scheme, for those without
this protection, members who first joined and some who returned to the
scheme after 6 April 2006, minimum pension age will change from 50 to 55
from 6 April 2010. 3 (amendment 63)
Definition of qualifying membership
11. Qualifying membership is membership that counts towards entitlement for

benefits. Pensionable membership is membership that counts when benefits
are calculated. This may be different from reckonable service for the purposes
of a redundancy payment as it can include pensionable service from previous
periods of employment with the NHS or another employer and periods of part
time working.
Use of redundancy payment to pay for early retirement
12. If the redundant member of staff chooses to take early retirement with an
unreduced pension under these arrangements, they will receive immediately
the full value of their qualifying pension benefits at the point of redundancy
without the actuarial reduction that would occur with voluntary early retirement.
Their employer will pay the relevant NHS pension scheme a sum equivalent to
the capitalised cost of paying the pension and lump sum early; either as one
payment or in five instalments. 4
13. This sum will be paid from the lump sum redundancy payment that otherwise
would have been paid to the employee. If the cost to the employer of paying by
single payment for early retirement is less than the value of the redundancy
payment that the member would have received under paragraph 8 then the
redundant employee will also receive from the employer a redundancy payment
equivalent to the difference between the two sums. The cost to the employer
would therefore normally be the same as if the employee had chosen to take a
redundancy payment without unreduced early retirement. However, if the cost
of early retirement is more than the redundancy payment due, the employer will
pay the additional cost. If the employer chooses to pay in five instalments, the
employer is responsible for the additional interest charge.
Treatment of concurrent pensionable employment
14. Where there is concurrent pensionable employment, members may choose

between:
Ceasing all pensionable employment and taking early retirement on the

terms set out below in respect of each employment in which case they
cannot be pensionable again in the current scheme (normal pension age of
60). (An employment may continue if it is not more than 16 hours a week,
without affecting the payment of enhanced benefits, but it will not be
pensionable in the scheme) and:
3
4
It is open to qualifying members to take early retirement under the normal scheme arrangements
for voluntary early retirement or normal age retirement.
85
Taking benefits only in respect of the employment that is being terminated,
in which case they can continue being pensionable in other employments.
After 6 April 2010, this will not apply if taking benefits under the age of
55.(amendment 64)
15. Members with concurrent practitioner and non-practitioner employments,

who choose to cease all pensionable employments, will receive only their
non-practitioner benefits on redundancy grounds. Where appropriate,
benefits for practitioner membership may be taken on an early retirement
basis with an actuarial reduction or preserved for payment at age 60. 5,6
16. The employer who authorises early retirement will be responsible for the
pension costs accruing from other terminating employment. If a member returns
to work after taking their pension, their pension will be abated, if the combined
value of their pension and salary is greater than they earned prior to retirement.
This will continue until they reach their normal pension age.
Exclusion from eligibility
17. Employees shall not be entitled to redundancy payments or early retirement on

grounds of redundancy if:
they are dismissed for reasons of misconduct, with or without notice; or

at the date of the termination of the contract have obtained without a break,
or with a break not exceeding four weeks, suitable alternative employment
with the same or another NHS employer; or
unreasonably refuse to accept or apply for suitable alternative employment
with the same or another NHS employer; or
leave their employment before expiry of notice, except if they are being
released early (see paragraphs 20 to 21 below); or
are offered a renewal of contract (with the substitution of the new employer
for the previous NHS one);
where their employment is transferred to another public service employer
who is not an NHS employer.
Suitable alternative employment
18. Employers have a responsibility before making a member of staff redundant or

agreeing early retirement on grounds of redundancy to seek suitable alternative
employment for that person, either in their own organisation or through
arrangements with another NHS employer. Employers should avoid the loss of
staff through redundancy wherever possible to retain valuable skills and
experience where appropriate within the local health economy.
19. Suitable alternative employment, for the purposes of paragraph 17, should be
determined by reference to Sections 138 and 141 of the Employment Rights
Act 1996. In considering whether a post is suitable alternative employment,
5
Where practitioner membership ended 12 months or more before the date of
non-practitioner retirement on redundancy, and all other posts have ceased, practitioner benefits will
be paid at the same time as the redundancy benefits and associated pension costs will be met by the
NHS employer authorising retirement.
6
Practitioners are general medical and general dental practitioners
86
regard should be had to the personal circumstances of the employee.
Employees will, however, be expected to show some flexibility.
20. For the purposes of this scheme any suitable alternative employment must be
brought to the employees notice in writing or by electronic means agreed with
the employee before the date of termination of contract and with reasonable
time for the employee to consider it. The employment should be available not
later than four weeks from that date. Where this is done, but the employee fails
to make any necessary application, the employee shall be deemed to have
refused suitable alternative employment. Where an employee accepts suitable
alternative employment the trial period provisions in Section 138 (3) of the
Employment Rights Act 1996 will apply.
Early release of redundant employees
21. Employees who have been notified of the termination of their employment on
grounds of redundancy, and for whom no suitable alternative employment in the
NHS is available, may, during the period of notice, obtain other employment
outside the NHS.
22. If they wish to take this up before the period of notice of redundancy expires the
employer will, unless there are compelling reasons to the contrary, release such
employees at their request on a mutually agreeable date. That date will become
the revised date of redundancy for the purpose of calculating any entitlement to
a redundancy payment under this agreement.
Claim for redundancy payment
23. Claims for redundancy payment or retirement on grounds of redundancy must

be submitted within six months of date of termination of employment. Before
payment is made the employee will certify that:
they had not obtained, been offered or unreasonably refused to apply for or
accept suitable alternative Health Service employment within four weeks of
the termination date;
they understand that payment is made only on this condition and undertake
to refund it if this condition is not satisfied.
Retrospective pay awards
24. If a retrospective pay award is notified after the date of termination of

employment then the redundancy payment and/or pension will be recalculated,
and any arrears due paid.
Disputes
25. An employee who disagrees with the employers calculation of the amount of
redundancy payment or the rejection of a claim for redundancy payment should
make representations to the employer via local grievance procedures. See also
paragraph 23 about making a claim for a redundancy payment.
87
Early retirement in the interests of the efficiency of the service
26. Members of the NHS Pension Scheme will receive payment of benefits without
reduction if they retire early in the interests of the efficiency of the service, and
they satisfy the qualifying conditions set out in paragraph 10. Retiring early in
the interests of the service is a flexibility available at employer discretion. In
these cases, no redundancy payment is due. In agreeing to retirement in the
interests of the service, the employer undertakes to pay the costs of paying the
pension and lump sum early. Employers will need to ensure that they exercise
this discretion appropriately and will be conscious of the implications of any
potential discrimination on grounds of age, gender, gender identity or gender
expression, pregnancy or maternity, marriage or civil partnership, race, religion
or belief, disability, or sexual orientation.66
27. These arrangements are aimed at employees who have given valuable NHS
service in the past but are no longer capable of doing so. This might be
because of new or expanded duties or a decline in the ability to perform existing
duties efficiently but not so as to qualify them for ill health retirement.
Employers would be expected to consider alternatives before agreeing to early
retirement, including reasonable adjustments to an existing role or potential
suitable alternatives.67
28. The relevant NHS pension scheme certifies the grounds on which early
retirement is taking place. The scheme does so on the basis of the information
provided by the employer. In each case, therefore, an appropriate senior
manager should authorise the early retirement, ensuring that the relevant
criteria have been met.
Employer responsibilities
29. Employer contributions to the NHS pension scheme do not cover the costs of
early retirement benefits. There is a requirement for NHS employers to pay
these costs if they retire staff early on grounds of redundancy or in the interests
of the service. 68
88
Schedule 27 Caring for Children and Adults (Temporary
Schedule)39
General
1. All NHS employers must have a carers policy to address the needs of
people with caring responsibilities and to meet the requirements of the
right to request flexible working legislation for carers of children and
dependant adults (see Employment Relations Act for definition of
carer). This policy should emphasise the benefits of employment
breaks, flexible working arrangements and balancing work and personal
life as set out in Schedules 25, 28 and 29.
2. The policy should seek to balance the requirements of delivering a first

class service with the needs of employees, to find the most effective
means of supporting those with carer responsibilities as part of a wider
commitment by the NHS to improve the quality of working life.
3. Many of the policies related to child and dependant care will have
relevance to other forms of care. For example the planning process for
checking out what would help eligibility criteria and ensuring equality of
access. These should be considered when drawing up a carers policy
Child and Dependant Care
4. Childcare covers a range of care choices for children from birth up to

age 14 years.
5. Dependant care covers a range of options to meet the needs of
dependant adults, including the needs of dependent young people over
the age of 14, where an employee is involved in substantial and regular
care sufficient for them to seek a change in their permanent contract of
employment.69
6. The policy should be drawn up jointly between employers and local staff
side representatives. This should cover:
- the child and dependant care needs of people relative to matters

such as place of work, working patterns (including shift patterns)
and hours worked;
- policy on child and dependant care support particularly related to
specific difficulties in recruiting and retaining people in certain
job categories;
- equality of access to child and dependant care and affordability,
respecting the diversity of personal domestic circumstances;
- guidelines on eligibility;
- how the policy relates to other Schedules, in particular those
covering leave and flexible working arrangements;
89
- the range of options open to carers, i.e. crche facilities,
childminders, workplace nurseries, allowances, school and
holiday play schemes, term-time contracts etc. The policy
should be clear as to why certain options are available;
- partnership options with other employers and trade unions;
- allocation of senior management responsibility for the operation
and monitoring of the policy
.
7. Where a decision is taken not to offer particular forms of support, the
policy should indicate where other arrangements are available to help
people with caring responsibilities, and what alternative ways of
working exist.70
8. Applications and outcomes should be monitored annually, in

partnership with local staff representatives.
9. Monitoring information should be analysed and used to review and

revise policies and procedures to ensure their continuing effectiveness.
10. Applications and outcomes, from both employer and employees should
be recorded and kept for a minimum of one year.
90
Schedule 28 Flexible Working Arrangements40
General
1. NHS employers in partnership with staff organisations will develop positive

flexible working arrangements which allow people to balance work
responsibilities with other aspects of their lives.
2. Employers are required to consider flexible working options as part of their duty
to make reasonable adjustments for disabled staff, staff with dependants and
job applications under the Equality Act and staff who are returning from
maternity leave (see Schedule 21).71
3. New working arrangements should only be introduced by mutual agreement,

whether sought by the employee or the employer.
4. Flexible working should be part of an integrated approach to the organisation of

work and the healthy work/life balance of staff.
5. Policies for flexible working should be made clear to all employees.
6. Employers should develop policies on flexible working which, as far as is

practicable, should include:
part-time working, where a person works to a pattern and number of

hours by mutual agreement;
job sharing, where two or more people share the responsibilities of one or
more full-time job(s), dividing the hours, duties and pay between them;
flexi-time, where employees can choose their own start and finish time
around fixed core hours;
annual hours contracts, where people work a specific number of hours

each year, with the hours being unevenly distributed throughout the year;
flexible rostering, using periods of work of differing lengths within an agreed

overall period;
term-time working, where people work during the school term but not during
school holidays;
school-time contracts;
teleworking, where people work from home for all or part of their hours with
a computer or telecommunication link to their organisation;
voluntary reduced working time, where people work reduced hours by

agreement at a reduced salary;
91
fixed work patterns, where, by agreement, days off can be irregular to
enable, for example, access by separated parents to their children and
flexible rostering.
Flexible retirement
7. Flexible working arrangements should be available to all employees.
8. All jobs should be considered for flexible working. If this is not possible the
employer must provide written, objectively justifiable reasons for this and give a
clear, demonstrable operational reason why this is not practicable.
9. There should be a clear procedure for application for flexible working, agreed
by employers and local staff representatives.
10. All people with flexible working arrangements should have access to standard
terms and conditions of employment, on an equal or pro-rata basis, unless
different treatment can be justified for operational reasons.
Monitoring and Review
11. Applications and outcomes should be monitored annually, in partnership with

local staff representatives.
12. Monitoring information should be analysed and used to review and revise
policies and procedures to ensure their continuing effectiveness.
13. Applications and outcomes, from both employer and employees, should be
recorded and kept for a minimum of one year.
92
Schedule 29 Balancing Work and Personal Life41
GENERAL
1. NHS employers should provide employees with access to leave

arrangements which support them in balancing their work
responsibilities with their personal commitments.
2. Leave arrangements should be part of an integrated policy of efficient

and employee friendly employment practices, and this Schedule should
be seen as operating in conjunction with other provisions particularly
the Employment Break Scheme, Flexible Working Arrangements and
the Caring for Children and Adults Schedules.
3. Arrangements should be agreed between employers and local staff

representatives.
4. A dependant is someone who is married to, is a civil partner, or a

partner (whether opposite or same sex), a near relative or someone
who lives at the same address as the employee. A relative for this
purpose includes: parents, parents-in-law, adult children, adopted adult
children, siblings (including those who are in-laws), uncles, aunts,
grandparents and step relatives or is someone who relies on the
employee in a particular emergency.72
FORMS OF LEAVE
Parental Leave
5. This should be a separate provision from either maternity or maternity

support leave and should provide a non-transferable individual right to
at least 18 weeks leave.72 Leave is normally unpaid, but may be paid
by local agreement.
6. Parental leave should be applicable to any employee in the NHS who

has nominated caring responsibility for a child under age 14 (18 in
cases of adoption or disabled children).
7. Leave arrangements need to be as flexible as possible, so that the

leave may be taken in a variety of ways by local agreement. Parental
leave can be added to periods of maternity support or maternity leave.
8. Notice periods should not be unnecessarily lengthy and should reflect

the period of leave required. Employers should only postpone leave in
exceptional circumstances and give written reasons. Employees may
also postpone or cancel leave that has been booked with local
agreement.
9. During parental leave the employee retains all of his or her contractual
rights, except remuneration and should return to the same job after it.
93
Pension rights and contributions shall be dealt with in accordance with
NHS Superannuation Regulations. Periods of parental leave should be
regarded as continuous service.
10. It is good practice for employers to maintain contact (within agreed

protocols) with employees while they are on parental leave.
11. This will apply to the father of the child (including adoptive fathers), the mothers
husband or partner (whether opposite or same sex), or nominated carer.73
12. NHS organisations have scope for agreeing locally more favourable
arrangements where they consider it necessary, or further periods of unpaid
leave.
Maternity support (paternity) leave
13. All employees are entitled to two weeks of ordinary maternity support
(paternity) leave which can be taken around the time of the birth or the
placement of the child for adoption.
14. In addition, employees may be entitled to take up to twenty six weeks of

additional maternity support (paternity) leave if their partner has returned
to work, the leave can be taken between 20 weeks and one year after
the child is born or placed for adoption.
15. To qualify for additional maternity support (paternity) leave the employee
and their partner must first meet certain qualification criteria. Details of
the qualifying conditions and the notification requirements can be found
at http://www.direct.gov.uk/en/employment/index.htm
Occupational pay during maternity support (paternity) leave
16. There will be an entitlement to two weeks occupational ordinary

maternity support (paternity) pay. Full pay will be calculated on the basis
of the average weekly earnings rules used for calculating occupational
maternity pay entitlements. The employee will receive full pay less any
statutory paternity pay receivable. Only one period of occupational
maternity support (paternity) pay is ordinarily available when there is a
multiple birth.
17. Eligibility for the two weeks of occupational maternity support (paternity)
pay will be 12 months continuous service with one or more NHS
employer at the beginning of the week in which the baby is due.
18. Employees who are not eligible for the two weeks of occupational
maternity support (paternity) pay may still be entitled to statutory
paternity pay subject to meeting the qualifying conditions. Details of the
qualifying conditions can be found at
http://www.direct.gov.uk/en/employment/index.htm
94
Statutory pay during maternity support (paternity) leave
19. To qualify for statutory pay in the additional maternity support (paternity)
leave period, the employee and their partner must first meet certain
qualifying conditions. Details of the criteria and the notification
requirements can be found at
http://www.direct.gov.uk/en/employment/index.htm
Rights during additional maternity support (paternity) leave
20. Employees who are entitled to additional maternity support (paternity)

leave/pay will be entitled to take up to 10 keeping in touch days during
the course of the additional maternity support (paternity) leave period.
The criteria for keeping in touch days is set out in Schedule 24 and is
based on those used for statutory maternity leave and pay.
21. Employees who have taken additional maternity support (paternity) leave
will have the right to return to the same job under their original contract
and on no less favourable terms and conditions.
Ante-natal leave
22. Reasonable paid time off to attend ante-natal classes will also be given.
Adoption Leave and Pay74
23. All employees are entitled to take 52 weeks adoption leave.
24. There will be entitlement to paid occupational adoption leave for

employees wishing to adopt a child who is newly placed for adoption.
25. It will be available to people wishing to adopt a child who has primary
carer responsibilities for that child.
26. Where the child is below the age of 18 adoption leave and pay will be
in line with the maternity leave and pay provisions as set out in this
agreement.
27. Eligibility for occupational adoption pay will be twelve months

continuous NHS service ending with the week in which they are notified
of being matched with the child for adoption. This will cover the
circumstances where employees are newly matched with the child by
an adoption agency.
28. If there is an established relationship with the child, such as fostering

prior to the adoption, or when a step-parent is adopting a partners
children there is scope for local arrangements on the amount of leave
and pay in addition to time off for official meetings.
95
29. If the same employer employs both parents the period of leave and pay
may be shared. One parent should be identified as the primary carer
and be entitled to the majority of the leave. The partner of the primary
carer is entitled to occupational paternity leave and pay.
30. Reasonable time off to attend official meetings in the adoption process
should also be given.
31. Employees who are not eligible for occupational adoption pay, may still
be entitled to Statutory Adoption Pay (SAP) subject to the qualifying
conditions. The rate of SAP is the same as for Statutory Maternity Pay.
Keeping in Touch
Work during the Adoption Leave Period
Keeping in Touch Days
32. Employees will be entitled to Keep in Touch Days (KIT) in line with the
maternity leave and pay provisions as set out in Schedule 24.
Leave/Time Off for Domestic Reasons
33. This form of leave should cover a range of needs, from genuine
domestic emergencies through to bereavement.
34. These provisions should cover all employees.
35. Payment may be made by local agreement, but the expectation is that
relatively short periods of leave for emergencies will be paid.
36. If the need for time off continues, other options may be considered,
such as a career break.
37. Applicants for the above forms of leave should be entitled to a written
explanation if the application is declined.
38. Appeals against decisions to decline an application for leave should be

made through the Grievance Procedure.
Monitoring and Review
39. All applications and outcomes should be recorded, and each leave
provision should be annually reviewed by employers in partnership with
local staff representatives
40. Applications and outcomes should be monitored annually, in

partnership with local staff representatives.
96
41. Monitoring information should be analysed and used to review and
revise policies and procedures to ensure their continuing effectiveness
42. Applications and outcomes, from both employer and employees should
be recorded and kept for a minimum of one year
97

Consultant Terms and Conditions

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Consultant Terms and Conditions

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Terms and Conditions Consultants (England) 2003

Version 1 - 20 October 2003

Supporting Professional Activities: activities that underpin Direct Clinical Care.

Additional NHS Responsibilities: special responsibilities not undertaken by the

For the purposes of Schedule 3, paragraph 6, non-emergency work shall be

Private Professional Services (also referred to as private practice): such

Professional and Study Leave: professional leave or study leave in relation to

Programmed Activity: a scheduled period, nominally equivalent to four hours,

General Council Conditions: The National Health Service Staff conditions of

On appointment to a Consultant post, Associate Specialists should be paid in line

16. The Job Plan will set out:

Resolving disagreements over job plans

5. The membership of the panel will be:

2. Where the unpredictable emergency work arising from a consultants on-call

3. The employing organisation will assess with the consultant, on a prospective

5. Table 1 illustrates possible ways of allocating Programmed Activities for these

6. Table 2 illustrates possible ways of allocating Programmed Activities for these

Table 2 Applicable from 1 April 2004

2. Where a consultant intends to undertake such work:

3. If a consultant declines the opportunity to take up additional Programmed

5. Should there be any significant increase in the time a part-time consultant

Unpredictable emergency work arising from on-call duties

Work in premium time exceeding three programmed activities per week

2. The only exception to this requirement is where a consultants on-call duties

High frequency rotas

4. Where unusually a consultant is asked to be resident at the hospital or other

Private professional services and fee paying services

2. The consultant is responsible for ensuring that the provision of Private

Disclosure of information about private commitments

Scheduling of work and job planning

6. Regular private commitments must be noted in the Job Plan.

7. Circumstances may also arise in which a consultant needs to provide

9. Where the employing organisation has proposed a change to the scheduling of

Scheduling private commitments whilst on-call

11. In addition, where a consultant is asked to provide emergency cover for a

Use of NHS facilities and staff

14. Should a consultant, with the employing organisations permission, undertake

Promoting improved patient access to NHS care

Increasing NHS capacity

3. A consultant must be contactable by telephone.

Public interest disclosure

3. For consultants subject to this Schedule, progression through pay thresholds

6. The employing organisation will credit appropriate additional seniority to reflect

7. Where a consultants training has been lengthened by virtue of being in a

Basic pay on commencement

9. Where a consultant holds discretionary points or a local clinical excellence

Table 1: Pay progression for consultants appointed before 31 October 2003

Seniority Pay scale

2. For consultants subject to this Schedule, progression through pay thresholds

Basic pay and pay thresholds

5. Basic salary on commencement will be set at a higher threshold to reflect any

6. Where a consultants training has been lengthened by virtue of being in a

Table 1: Pay progression for consultants appointed on or after 31 October 2003

Threshold Years Period before Payroll point

2 1 1 year MC72 Point 01

3 2 1 year MC72 Point 02

4 3 1 year MC72 Point 03

5 4 5 years MC72 Point 04

5 4 years MC72 Point 05

6 3 years MC72 Point 06

7 2 years MC72 Point 07

8 1 year MC72 Point 08

6 9 5 years MC72 Point 09

10 4 years MC72 Point 10